Silicon Valley entrepreneurs and health care leaders can learn a lot from each other, and the gains to patients and health care consumers could be extraordinary, leaders from Stanford Health Care leaders said at a recent AHA meeting.
“There is an opportunity for us to take this digital age as we’re thinking about it and make a real impact on the way that we provide care,” said AHA Board Member David Entwistle, president and CEO of Palo Alto, Calif.-based Stanford Health Care.
Understanding each other’s culture
Stanford Health Care leaders highlighted inherent discrepancies in how the technology industry and health care field operate. For digital technology – their leaders tend to move swiftly, while hospital and health system leaders tend to move more cautiously.
Lloyd Minor, M.D., Carl and Elizabeth Naumann Dean of Stanford University School of Medicine, said knowing these differences can help hospital and health system leaders better understand and respond to inquiries, ideas and proposals.
“Digital technologies have disrupted and radically changed every sector of the economy except for health care,” Minor said. “Every other sector in the economy is radically different today than it was a decade ago because of digitally-facing, consumer-engaging technologies – but we have some catching up to do in health care.”
When consumer devices cross into health care, get involved
Though the health care field has made great strides in the past decade digitizing medical records, “the data is still not, by and large, interoperable or exchangeable,” Minor said.
“By partnering with really strong tech companies, we have had the opportunity to do things in medicine and research at a scale that was never before possible,” said Mintu Turakhia, M.D., executive director of the Stanford Center for Digital Health.
Turakhia, the co-principal investigator for the Apple Heart Study, and a Stanford team collaborated with Apple to design and perform a large clinical trial to determine whether the Apple Watch could be used to identify atrial fibrillation and other irregular heart rhythms, which often go undetected but can cause stroke and other severe consequences. The trial has enrolled over 400,000 participants.
Tech companies entering the health care space come with new perspectives that help us think differently, but may need to be fine-tuned based on the complexities of medicine and the health care system, Turakhia noted, which is why it is imperative for health care leaders to be involved from the beginning.
“There’s tremendous opportunity in the tech world to advance products very broadly,” Turakhia said. “At the same time, we need to partner with tech companies to carefully and responsibly test these technologies before introducing them at scale. Together, academic medical centers, tech companies and health care systems can more effectively design studies, execute them and really help formulate how these products will touch and interface with the health care system.”
“These collaborative efforts tend to move at a faster pace than the academic and health care environments have historically operated,” Turakhia said. “Working with technology companies has really pushed us to rethink our models of collaboration, management and execution, and how we can be nimble and move quickly while still doing high-quality work. We have implemented a lot of what we have learned from tech, and it’s working well.”
Entrepreneurial spirit drives improvements in patient experience
A group of computer scientists at Stanford worked with Stanford Medicine’s dermatologists to develop a deep learning-based algorithm that uses only two sources of information – the pixel data of a smart phone photograph from a skin lesion, and the pathologically confirmed diagnosis of that lesion – to diagnose those lesions as accurately as a trained dermatologist, Minor said. In some instances, he said it could even distinguish benign from malignant melanoma more accurately than dermatologists.
“The ability of technology to radically positively disrupt our ability to deliver health care is growing at a prodigious pace,” Minor said. “That’s why it behooves us to work through the challenges, blend the cultures, and be able to do our work much more effectively.”
Technology also allows health care leaders to put the patient at the center of a user experience, said Sam Gambhir, M.D., chair of the Stanford University School of Medicine’s department of radiology. When Stanford’s head of interventional radiology, Rusty Hofmann, M.D., learned of his young son’s rare liver disease, he set out to co-found a company that would empower patients by offering them access to the world’s best physicians. Grand Rounds, a company Hofmann grew to 300 employees, now serves hospitals nationwide.
“It’s a very powerful model … and these kinds of tools are very rapidly evolving,” Gambhir said. “What I love at Stanford is that the entrepreneurial culture is exactly what’s driving faculty themselves to find solutions to empower consumers.”
Beyond wearables, the future of health care … in your home
The future of health care could resemble the world of science fiction.
“The area of tools I’m most excited about that we are working with Silicon Valley on, are tools that will live in your home,” Gambhir said.
Data show that people tend to toss their wearables like smart watches after a few months, Gambhir said. If devices fail to provide sustainable health care data, Gambhir said the field needs to find other ways to strategically monitor patients’ health over the long run.
Patients often are frustrated when doctors cannot quickly and accurately diagnose them, but taking one snippet of someone’s life is like coming into a movie theater three-quarters through the show and being expected to know what is going on, Gambhir said.
Gambhir already has had discussions about the “smart toilet,” which would be deployed in clinical trials so that the toilet could look for diseases based on an individual’s risk, such as blood in the urine or stool, infection, etc., he said. In addition, he discussed how a “smart mirror” could use machine learning to detect subtle changes in a person’s face or pulse to predict not only acute disease but chronic disease.
“I think we’re going to see a whole explosion of in-home technologies that fully communicate with the health care system that are already happening with the help of multiple companies,” Gambhir said. “Technology enables us to shift this dialogue in order to be proactive in health care and focus on precision health instead of just precision medicine alone.”
Building relationships to forge the path forward
Silicon Valley entrepreneurs have a lot of money to invest, but they need to be able to move quickly, Entwistle said.
Minor agreed hospitals must work on pace and reaction time in order to move forward in this space. However, he emphasized the need for developing a set of policies around collaborating with tech groups. In addition, he stressed the critical importance of hospital and health system faculty possessing the freedom and integrity to have the final say on a finished product or published study.
By forging partnerships, Minor is confident the two industries can teach each other in an effort to improve quality of life for patients.
“There’s a genuine interest from tech people with brilliant minds in adding value to health and wellbeing,” Minor said. “It’s profoundly motivating to see these engineers want to understand the dilemma that practicing physicians face.”
Gambhir added that health care leaders should constantly be talking to Silicon Valley executives, knocking on doors, and educating them, instead of being reactive and watching this new digital age unfold.
“You’d be surprised how receptive a lot of these companies are to big, ambitious, bold projects,” Gambhir said. For more on health innovation and the latest market intelligence, visit the AHA Center for Health Innovation at www.aha.org/Center.