I had a chance to interview Amir Dan Rubin, President and CEO of Stanford Health Care (SHC), at the Personalized Medicine World Conference (#PMWC15) in Mountain View, California on 01/26/15. We talked about how SHC seeks to heal humanity through science and compassion, one patient at a time. In the video, Amir describes how they are doing that in four key strategic areas: care of complex conditions, care across a growing network of care, population care, and virtual care.
Complex care innovations
Amir provided some specific examples of innovations in each of the strategic areas, beginning with complex care. As an example of what they are doing in the arena of personalized (or precision) medicine, he described a research study being led by one of Stanford’s faculty members, Irving Weissman, MD, the Virginia & D.K. Ludwig Professor for Clinical Investigation in Cancer Research and a Professor of Developmental Biology.
Dr. Weissman has identified a marker on every cancer cell, CD47, that tells the immune system not to eat it. He has also developed an antibody that turns this marker off, thereby shutting off the “don’t eat me” signal. The hope is, by doing this, it will let the immune system know that these cancer cells are unwanted and should be attacked and destroyed.
Another precision medicine study Amir described involves using genomic sequencing to detect cancer via circulating DNA in the bloodstream. The hope is that cancers can be detected earlier by this blood test including detecting recurrences in patients that have already been treated. Although there has been some recent press about using this type of test to detect breast cancer, Amir said the hope is that this test will be used for multiple different types of cancer. A study to determine the effectiveness of this test in comparison with more conventional imaging and other diagnostic approaches is underway right now.
Stanford doesn’t want to “just create the leading edge, we also want to deliver care in a highly coordinated way,” so, they are re-envisioning patient care. Stanford Health Care’s patient satisfaction scores are already quite high, but Amir said, “patients don’t just want good service every time they come to visit us. They want much more—an integrated solution to all of their problems.” Here is what he said Stanford patients want from their clinicians:
- “Know me
- Know who I am
- Know my preferences (and increasingly know my genome)
- Show me the way
- Help me make decisions through my life in my healthcare journey
- Coordinate for me
- Own the complexity of care“
In response, Stanford has launched health navigators and genomic counselors and new online tools to help patients navigate their way through their complex care conditions
Innovations across networks of care
SHC is also innovating across a network of care. They are developing regional health centers where multiple specialties are housed in one building so “with one call or click, you get it all.” For example, their new neuroscience building has 27 neuro-specialties in one place facilitating a multidisciplinary review of cases and personalization of the care.
SHC is also starting to explore incorporating coordinated, personalized care into accountable care/population care. They have launched the Stanford Health Care Alliance, a health plan, as well as Stanford Health Care Advantage, a Medicare HMO. These plans are not only trying to be sure populations are not just screened for conditions according to guidelines, such as breast and colon cancer, but also that principals of personalized medicine means are taken into account. “Each of us is different, so, maybe I need to be screened at an earlier age than someone else. We are actually using precision or personalized medicine approaches in our plans
Innovations in virtual care
Describing innovations in virtual care, Amir said, “At Stanford, we have launched care in the cloud. Your files and music are in the cloud, and now some of your care will be in the cloud too.” Some SHC patients will be able to get some of their care from home via Stanford ClickWell Care which allows you to book an appointment and have a video visit with a clinician online. You can also have your medications delivered to you. This is a long ways from the physician-centric office visits of the past. SHC is also using mobile to connect patients to their physicians and they are increasingly using “connected” devices. Further, there are advances in diagnostics that will eventually mean you won’t have to go to a hospital or a clinic to get them, rather, you will be able to do them at home.
An exciting time in healthcare
Amir closed the interview by saying,
“It is an exciting time at Stanford and, really, an exciting time in healthcare. I am so bullish on the opportunities for us to truly deliver integrated solutions, not only to medical care but also to health and well-being. And that really is the promise of personalized and precision medicine.”