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Interview in Action @ HLTH '23 - Ron Li, MD, Medical Informatics Director, Stanford Health Care

October 19: Today on the Conference channel, it’s an Interview in Action live from HLTH with Ron Li, MD, Medical Informatics Director for Digital Health at Stanford Health Care. Playing a crucial role in shaping and implementing new digital health programs, particularly virtual health models at Stanford Medicine, Li discusses the hurdles faced by clinicians in synchronizing with the rapid technological advancements. Does the overabundance of data create a kind of 'information overload' for physicians? How can the balance between human-driven processes and tech intervention be optimized for efficient patient care? As we explore the possibilities of virtual care models, Lee enlightens us on how technologies like AI can revolutionize the future of health informatics. He also shares his intriguing insights into Stanford's Emerging Applications Lab's aims and functions and the intricacies of balancing between virtual and traditional healthcare paradigms.

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This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Welcome to This Week Health Conference. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a set of channels and events dedicated to leveraging the power of community to propel healthcare forward. Today we have an interview in action from the Fall Conferences on the West Coast.

Here we go.

Alright, here we are at Health 2023 for another interview in action. We're joined by Ron Lee with Stanford Medicine. Ron? First of all, give us an idea of your role at Stanford.

Sure. I'm an internal medicine physician. Faculty in And I work for Samford HealthCare, which is the health system associated Samford Medicine as the medical informatics director for digital health.

So I'm in our chief medical information officer's office. And basically I think of my role as kind of elevating the clinical voice as we scope, implement new digital health programs. Mostly virtual health model things of that nature. I think a lot about the physician experience, how we integrate other aspects of our tech stack to enable some of these care models that are, that's very important to the growth of our organization.

And then as part of that role, I actually uh, lead a group called the Stanford Emerging Applications Lab, which I see as kind of the most R& D arm of the Office of the CFO. So it's a way for us to create, co ideate de risk newer technologies, what we call emerging applications that we think could actually solve pain points for physicians.

Solutions that aren't available in But, not quite ready for us to engage as and we, And we have this little group that actually has an engineering group. You know, We can build our own applications, we can co create, co design, and produce these programs as a way for us to learn about our own clinicians and see what's out there.

Potentially strategically inform what we eventually can actually use at

the what's the problem set? I mean, what's the problem set specifically for clinicians today? You're looking.

Well, I would say it's probably similar to the problems that we've been facing the last 10 years. It hasn't really changed unfortunately.

And I think, as you I'm sure have heard from deal with the increasing volume. Increase and modifications, all of which aren't bad things per se, but it's just that the way we practice hasn't adapted to allow the average position to be able to deal with that. So for example, if we're, if one of our goals is to expand the number of touchpoints with a patient.

I mean, that's a good thing. We want that because we want patients to get access. We want data. But ultimately, a person has to do something, right? In order for that patient to become healthier. We still have to rely on, clinical students to assess the patient to use that data and ultimately prescribe, medication for surgery and whatnot.

But it's still a very human driven process. And I still think we haven't quite figured out how to actually, allow our workforce to take in the data that we already have, much less additional data that's going to be generated from all these technologies, in a way that, allows the patient to actually be taken care of, and frankly allows our workforce to do it well.

So it's the same thing, and I think that now it's even more important because... We now have all these tools available. We actually have more of a need to use virtual to expand our reach. So we have to make sure

our, our, our physicians are able to

actually take care of patients in that environment. I assume at Stanford your virtual Or do you have the silo problem that some others do? 

I'm sure there are always silo problems, but I think a core principle is absolutely has

to be fully integrated. These are always a trade off. So, sometimes, for example, we work with Seal, this group that I'm on. We do a light lead integration because we don't want to spend uh, 500, you know, IT hours in the full integration. Because we just want to see, at a high level, is this even working.

But absolutely, I think anything else, and if we want this to be a core part of our care model transformation, EHR is how we deliver care. 📍

  📍 We'll get back to our show in just a minute. We have an excellent webinar coming up for you in November. We had an excellent conversation about AI in September with three academic medical centers around the topic of artificial intelligence.

It really was exceptional, and we released it on our podcast channel so that we could share it with a wider audience. I wanted to explore that topic a little bit more, and I asked a couple of additional health systems to join us to explore the use of generative AI and other forms of artificial intelligence to see if we can identify some pragmatic approaches to how health systems are looking at taking advantage of this technology.

The webinar is on November 2nd, 1pm Eastern Time, 10am Pacific Time. You can reserve your spot on ThisWeekHealth. com and one of the things we love is that you can submit your questions in advance and we can make sure that we, answer those questions and keep the webinar relevant to the things that you're looking to talk about.

So, please join us November 2nd, 1 p. m. Eastern Time, 10 a. m. Pacific Time. Now, back to our show. 📍

 So, virtual

care has gone obviously during the pandemic, well, way up. Yeah. Significant number of visits. And it came back down and sort of settled at a percentage higher.

Are we seeing that stay the same, or is it growing, or is it still decreasing a little bit?

we've seen the same pattern, right? I mean, at the height of the pandemic, well, pre pandemic, we're in the single digits. And it took a while to convince people that this is a real thing. I mean, there were the early adopters, but I think only the early adopters were using right? And then now I think we're back down. I don't know the exact same number, but I know that we actually are actually a bit higher CEO at the most But we are actually a bit higher than operational. There are many reasons for that. It is, I would say we're not, we're definitely not at the growth phase.

In some ways, I think that's okay. I think what we are now is, I think, we're much better at discerning what should be virtual, what should not be virtual, how do you optimize the virtual experiences, and also virtual doesn't just have to be video, right? Video is kind of the first stage. the video. I mean, of course, there are asynchronous modalities. We explore. Econ is a very popular one. I just think of these as building blocks that even by itself is valuable. But imagine what you can do if you were to piece together these building blocks into the creation of a new tier model that allows us to solve a specific problem.

It comes to access. I think that's kind of where we are.

So AI sort of hangs over the rafters of that entire floor in there. And then the music has picked up here as well, so Health sort of does have a NetClub feel to it, doesn't it? But it has AI sort of hanging over there. Will AI impact the virtual visits, the telehealth side of the business?

I hope so. That's exactly what I'm focusing I think what I like about what we're starting to see, even though it's I think AI is the product. We're deploying AI. We're deploying machine learning models. I

mean, I think we still do that to an extent. What I actually really like about digital health and what I do is, I think of AI as a lubricant, as an enabler. It's a feature of a product that is much bigger than just AI. So if you think about... The product being, let's say, you know, a new type of asynchronous care model where we can actually expand specialty care to a larger caching area.

And we have a, we have to have a staffing model, specialists and whatnot. Like the product is the care, it's the service, right? Then if you, I always like to take a value chain analysis approach. So if you take a value chain What prevents us from scaling this program? Well, I mean, one, one reason is that we just don't have enough people to take in all these consultation requests and service them, right?

Why not? Because they take 15 minutes to have to look through the chart if they get a new consult or some type of request. They have to, peruse through this pile of, this is, chump of text. Sometimes the consult question that's submitted

to because they're busy. So there's a lot of stuff that they have to do in order to just actually deliver these metrics. That's where AI comes in, because then becomes, then you identify the problem. The problem is, how can we more efficiently, for example, Synthesize large amounts of text and extract the key pieces that will enable the consultation such that the human specialist can 15 minutes 2 see where I'm getting at right, so now with large language models, you can see how that could actually be helpful.

So that's how I think about it, it's like, AI is a, it's a enabler, it's a feature, it's a tool that allows us to be, it takes 15 minutes, this product won't be possible. Yeah, so that 10 minute key.

FHIR consultation ends up expanding the staff potentially to reach scale.

I mean, it would make the unit economics possible. It would just make it possible. So I think that would be an example of a type of, how we would think about integrating

AI to thank you for your time. Appreciate it. Of course. Look forward to catching up again. Yeah.

  Another great interview. I want to thank everybody who spent time with us at the conference. I love hearing from people on the front lines. It is phenomenal that you shared your wisdom and experience with the community and we greatly appreciate it. We also want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders.

They are CDW, Rubrik, Sectra, and Trellix. Thanks for listening. That's all for now.


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