Health Tech: Abbott’s Dr Robert L Kormos On How Their Technology Can Make An Important Impact On Our Overall Wellness

An Interview With David Leichner

Reliability. The key goal here is to impart a safety profile for the technology that aims to create optimal mechanical, electrical, chemical, and biological compatibility.

In recent years, Big Tech has gotten a bad rep. But of course, many tech companies are doing important work making monumental positive changes to society, health, and the environment. To highlight these, we started a new interview series about “Technology Making An Important Positive Social Impact”. We are interviewing leaders of tech companies who are creating or have created a tech product that is helping to make a positive change in people’s lives or the environment. As a part of this series, I had the pleasure of interviewing Dr. Robert L. Kormos.

Robert L. Kormos, M.D., is divisional vice president, global medical affairs, for Abbott’s heart failure business. He was previously a deputy director at the McGowan Institute for Regenerative Medicine at the University of Pittsburgh Medical Center. While at the University of Pittsburgh, Dr. Kormos’ research and clinical interests focused on mechanical circulatory support for advanced heart failure, resulting in his contributions to over 340 published articles.

Thank you so much for joining us in this interview series. Before we dive in, our readers would love to learn a bit more about you. Can you tell us a bit about your childhood backstory and how you grew up?

I grew up on a tobacco farm in Southern Ontario, between Detroit and Toronto along the lakeshore of Lake Erie. I spent my early years working with my dad on the farm. I’ve always been inclined to examine and take things apart, like on my dad’s tractor, and very interested in science.

When I graduated from high school, I went to the University of Western Ontario where I got my bachelor’s degree in physiological psychology — essentially the psychology of perception. A lot of what I studied focused on how people’s perceptions can be fooled, which was an interesting entry into neurology. When I got into medical school, I spent a lot of my free time learning about neuroscience, which caught the attention of the neurosurgeons at the University of Western Ontario’s neurosurgery program. They offered me a job in London, Ontario, which was known worldwide at the time for its innovation in neurosurgery. After finishing my internship in Toronto, which included a rotation in neurosurgery, I was offered an opportunity to join their neurosurgery residency program.

During my time in the neurosurgery program, I did a rotation in cardiac surgery working with world-class cardiac surgeons. One of the surgeons, Hugh Scully, encouraged me to consider completing my cardiac surgery residency as he felt I was better suited to be a cardiac surgeon. Ultimately, I made that transition to cardiac surgery. During that time, Hugh got me involved in motor racing. I saw parallels between surgery and motor racing, as they both required similar accuracy, attention to detail and focus on dexterity. One needs to be focused in the moment and not distracted. Hugh then introduced me to motor racing safety, which required rapid assessment of a driver in a racing incident with the goal of extracting the driver from the car if need be.

Can you share the most interesting story that happened to you since you began your career?

When I started my surgical training in Toronto, I happened by a bookstore that was hosting a book signing with Andy Warhol. I was early and so it was just myself and Andy. He was very personable, and I told him I was going to be a cardiac surgeon and interested in artificial hearts. That’s when he said, “I don’t know where the artificial stops and the real starts.” That comment has driven me ever since — when you’re doing something with technology, especially implanting LVADs (Left Ventricular Assist Devices) and artificial hearts, you must consider how you present it to a patient in a way that they consider it part of themselves. It becomes their reality. And that has always been one of my focus areas when looking at technologies in general — how does the technology integrate with the person so that it becomes part of their life?

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

Yes, besides the stewardship of my parents and many collaborators along the years, the one person that stands out is Harvey Borovetz, the former Chair (2002–2013) of the Department of Bioengineering at the Swanson School of Engineering at the University of Pittsburgh. When I first arrived in Pittsburgh in 1985 as a young graduate cardiac surgeon, it was Harvey who took me everywhere to meet all the pioneers in the field of artificial organs and brought me with him to the important National Heart, Lung and Blood Institute (NHLBI) and research meetings because I think he saw that the spark had been lit in me and he wanted to get that fire burning strong. He provided a lot of great ideas that I was able to translate into clinical program action.

My clinical supervisor was Bartley P. Griffith who was a great visionary and provided me with clinical training opportunities to grow in the field. Dr. Griffith recently performed a porcine xenograft heart transplant.

Another person who had a big impact on me was a patient of mine. I always like to learn about what my patients do for a living, and this man with severe heart failure told me he liked to create companies and that was all he said. He happened to be Bill McGowan, the founder and chairman of MCI Communications. He gave me a lot of support and helped us start the McGowan Institute for Regenerative Medicine at the University of Pittsburgh, which allowed us to do the research that led to the development of Abbott’s HeartMate II LVAD.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

The one that has stayed with me is from my grandmother — “When one door or window closes, another one opens.” That probably has gotten me through more hurdles than anything else. The number of times I’ve been told I can’t do something has occurred so frequently that I usually ignore it now. Like when I was told I would never get into medical school or become an academic cardiac surgeon.

When I decided to be a cardiac surgeon, I was told I couldn’t work in Toronto because I had not yet done enough basic science cardiac research. So, I called Bartley Griffith at the University of Pittsburgh Medical Center, and he said I could do a fellowship with him in transplantation and be part of their program for artificial hearts. The only problem was they didn’t have money to pay me for the first year.

What I learned in my life, as a young person and as a motor racer, is how to take calculated risks. Going to Pittsburgh for the fellowship was a gamble I felt was worth taking.

I joined the University’s artificial heart program, and within five years, was running the LVAD and mechanical circulatory support (MCS) program. Working with Dr. Griffith and Dr. Borovetz, we received an NHLBI grant to design and test a new heart pump. My part was to run the lab that did all the initial research on the HeartMate II, which led to my doing the first human implant of the HeartMate II in Israel in 2000.

You are a successful business leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

Persistence, adaptability and recreating yourself when necessary are key, but it’s also important to always put human interaction at the top of everything. The relationships we form are so important.

While I was doing cardiac surgery in Toronto circa 1980, I attended a meeting of the American Society of Artificial Internal Organs and listened to presentations on the first total artificial heart and got so excited about the field of mechanical circulatory support. After that, I created the first LVAD program in Canada. We supported about four to five heart failure patients, including a patient whom I couldn’t wean from the circulatory assist device. I called around to transplant centers to try to find her a heart, but was told by Dr. Griffith that he couldn’t see us ever transplanting someone who is being artificially supported on a pump.

Later, I was able to call on Dr. Griffith for the fellowship opportunity. Together, we built an incredible regenerative medicine program in Pittsburgh. Years later, I was at a medical meeting and someone from Abbott came up and said they were looking to hire a medical director and asked if I was interested.

Ok super. Let’s now shift to the main part of our discussion about the technology or medical devices that you are helping to create that can make a positive impact on our wellness. To begin, which particular problems are you aiming to solve?

Our overall vision in the heart failure division at Abbott is to help people with heart failure
survive and thrive. We strive to pioneer and increase access to life-saving, connected innovations that empower people to take control of their health by delivering seamless clinical solutions from diagnosis to monitoring and treatment. Our North Star is to research and develop technology that is more integrated into people’s lives.

More than 6.2 million Americans have heart failure, which is projected to increase 46% from 2010 to 2030, increasing to over 8 million adults in the United States. The number of deaths attributable to heart failure was 42.3% higher in 2017 than it was in 2007. Historically, many advanced heart failure patients who don’t qualify for a heart transplant rely on medication or are referred to palliative care to manage symptoms. Thousands of people with advanced heart failure die every year because they do not receive a heart pump, largely because their physicians are not aware of the option or its full benefits. There are too many patients who aren’t provided the opportunity to be evaluated for a heart pump, such as patients with obesity, diabetes, certain cancers and blood types or those from underserved communities across the United States.

How do you think your technology can address this?

Our collective mission is to take all our technologies and create a seamless platform where they all talk to each other. How do we as Abbott connect all our implantable devices? One of our goals is to make our technologies work together so a patient can get all the information they need about their health.

Newer technological advancements like Abbott’s HeartMate 3 LVAD can provide a life-prolonging option for advanced heart failure patients. The benefits of heart pumps are especially true for the estimated 15,000 advanced heart failure patients whose median lifespan is under a year because they are on inotropic medication alone. While some of these patients await a donor heart, due to a limited number of organs available, heart pumps like the HeartMate 3 can improve survival while offering immediate, significant and sustained quality of life. With expanded clinician awareness of the benefits and improved access to a heart pump, we can give these patients a chance at a longer, fuller life.

The HeartMate 3 is a technological marvel. It’s an implantable device that pumps blood through the body in people whose heart is too weak to do so on its own. It is the only commercially approved heart pump with Full MagLev™ technology, which allows the device’s rotor to be “suspended” by magnetic forces. This unique design has been proven to reduce trauma to blood passing through the pump, improving patient survival and quality of life. These factors along with its ability to produce an artificial pulse, results in the lowest rate of pump-related complications, such as stroke, of any other blood pump.

Can you tell us the backstory about what inspired you to originally feel passionate about this cause?

When I treated the first patient in Canada with an early rotary blood pump used as an LVAD, I stayed at the hospital for four days because I was the only one who knew how to support this patient’s heart. The morning we discontinued support of that patient with the pump, because they had recovered, is burned into my memory. I walked to the garage, got into my car and watched the sunrise for about ten minutes. I couldn’t move. I realized then that was what I wanted to do — to have the ability to help a person who was going to die, recover their heart function. That completely changed my life.

How do you think this might change the world?

Heart failure has a five-year survival of about 25%, which is so much worse than most cancers (Breast = 73%, Prostate = 58%, Colon = 43%, Rectum = 43%, Lung = 10%.) By making an impact in heart failure mortality, we can make a huge impact in saving lives.

This summer, we presented new data that found the HeartMate 3 extends the survival of advanced heart failure patients by at least five years — the first time a heart pump has been shown to extend survival five years and beyond. This was from our MOMENTUM 3 trial, the world’s largest randomized clinical trial to assess long-term outcomes in people receiving a heart pump to treat advanced heart failure. MOMENTUM 3 also found that the five-year survival for HeartMate 3 patients (nearly 60%) is approaching the five-year survival rates of heart transplant recipients who have a similar risk profile.

The finding that the HeartMate 3 device can reliably add years to one’s life is compelling evidence for all cardiologists to evaluate their patients with progressive heart failure for this therapy.

We are very encouraged by these data points because they demonstrate the benefits of heart pumps. We are committed to raising awareness with physicians to help them explore this life-enhancing and life-prolonging alternative for their patients.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this technology that people should think more deeply about?

This gets back to the concept that patients aren’t patients — they are humans with diseases. We have to preserve the patient/physician bond. Patients need to know there is a human being looking after them, not a machine or an algorithm or artificial intelligence. Those are tools meant to aid physicians in maintaining the efficient care of patients, but not to completely replace the care of patients.

In designing and developing new technology, the technology must be integrated into the perceptions and lifestyles of the person who will be using it. Engineers developing new technologies use complex information-gathering algorithms obtained through clinician and patient interviews to help them better understand how technology can seamlessly integrate into a patient’s life. The goal is to anticipate and reduce unintended consequences.

Here is the main question for our discussion. Based on your experience and success, can you please share “Five things you need to know to successfully create technology that can make a positive social impact”?

The overall goal of health technology should be to improve health and to increase patient engagement in their health, which in turn promotes the ability for patients to be productive members of their community and family.

There are five key points that one should consider in creating new technology with impact:

a) Performance. The technology must have impact in changing the course of the patient’s heart failure journey. It must create the maximum benefit to health and is often referred to as efficacy. In the case of a heart pump, it results in maximal unloading of the heart to relieve congestion and supports a normal blood pressure. In general terms, the technology must achieve its indication for use.

b) Reduce the time a patient spends in the hospital during their illness. The technology must allow patients to continue to live their lives in their community and at home. The technology must be as non-invasive as possible with the shortest time possible sent in the operating room or ICU.

c) Reliability. The key goal here is to impart a safety profile for the technology that aims to create optimal mechanical, electrical, chemical, and biological compatibility.

d) Quality of Life: More and more clinical studies with medical technology have incorporated as part of their outcome measures, studies of quality of life before and after the implementation of a given technology. These studies include both functional measures of exercise tolerance as well as specific quality of life metrics in a number of domains that measure patient satisfaction and the ability to resume activities previously given up in their disease state. The studies have successfully shown that with many health technologies people regain both functional and life satisfaction levels that exceed those seen previously with the disease state.

e) Cost. The total cost of heart failure is projected to increase 127% to $69.8B by 2031. Our technologies are designed to reduce the overall cost of heart failure by reducing the number of hospital readmissions.

Overall, as new technologies are introduced into health care the cost equation needs to address the needs of the health care universe as a whole, taking into account the cost to patients, hospital administrations, healthcare payers and the cost to physicians in the community handling the burden of heart failure.

Can you share a few best practices that you recommend safeguarding your technology or medical devices from hackers?

If you could tell other young people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?

Put people first.

Reward comes back to you because the people who benefit will provide feedback and affirmation that they appreciate what you’ve done. People like to hear that they did a good job or something important. It means something when you embed yourself in a lifestyle that touches people, who will then come back and tell you what a difference you made in their lives.

Is there a person in the world, or in the US with whom you would like to have a private breakfast or lunch, and why? He or she might just see this, especially if we tag them. :-)

Not one specific person, but someone who has the influence and capability to create change. Someone that could listen to the story about the gap between the knowledge of what heart failure is and the reality of how many patients go unrecognized and die without a chance for therapy. We need to raise awareness about heart failure like many do for cancer. So many women and men live with the bias that their limitations are due to chronic lung disease, diabetes, obesity or being out of shape, when, in fact, they are dying slowly of congestive heart failure. This gap is most apparent on a cultural, racial and economic level. These patients need a voice, and maybe it’s a passionate voice.

How can our readers further follow your work online?

Readers can follow me on LinkedIn at @Robert Kormos. I am also a frequent speaker and panelist at cardiology and medtech conferences, offering my industry expertise on the latest medical device innovations, management and treatment guidelines for heart failure and other clinical milestones and advancements.

Thank you so much for joining us. This was very inspirational, and we wish you continued success in your important work.

About The Interviewer: David Leichner is a veteran of the Israeli high-tech industry with significant experience in the areas of cyber and security, enterprise software and communications. At Cybellum, a leading provider of Product Security Lifecycle Management, David is responsible for creating and executing the marketing strategy and managing the global marketing team that forms the foundation for Cybellum’s product and market penetration. Prior to Cybellum, David was CMO at SQream and VP Sales and Marketing at endpoint protection vendor, Cynet. David is a member of the Board of Trustees of the Jerusalem Technology College. He holds a BA in Information Systems Management and an MBA in International Business from the City University of New York.