Healthcare PittStop: 10 years and 2000 proposed innovations at Kaiser- a conversation with Dr. Yan Chow

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Dr. Yan Chow is the former Medical Director for Kaiser’s Innovation and Advanced Technology Group (IAT) housed at the Garfield Center in Oakland California. During his tenure the Center welcomed over 55,000 visitors and evaluated over 2000 technologies with a focus on analytics, telehealth, and wearables. Dr. Chow has 3 patents. He has also worked in the federal space in his role at Longview International Technology Solutions. He ihas worked now an independent consultant, advising others on medical innovation. Most recently he has taken a role with Amgen.Dr. Yan Chow

 

Welcome to Healthcare PittStop, Yan. You have such a long history in innovation. What motivates you? What gets you up in the morning?

 

One of my main motivations is the growing discrepancy between what’s happening is society and what’s happening in healthcare, not just in technology but in public policy, social change, social media, the establishment of new power centers and so on. How do we as a health care provider—a physician—bridge that gap between where technology is going and how fast it’s going and what we are doing today in health care.

 

I’ve followed how you look at other technologies and for applications in healthcare. Clearly other markets are moving much faster than healthcare. What do you think are the main problems that we could solve with technology?

 

You have to look at the technologies that are closer to reality. Technologies like genomics, VR, AR, robotics—those things are great but they’re still 10 or 15 years away. Three areas are closer to reality. The first is telemedicine, which has been around a long time but is just taking off because of the financial pressures. The second is mobile health; mobile health has become the de facto standard for consumer electronics, so it’s beginning to affect health care in a big way That signals a lot of change in the relationship between the healthcare provider and the consumer in terms of the availability of healthcare information right at the pocket, as opposed to having the patient go somewhere to do something. And a third area is analytics, which is starting to come on strongly and to be funded by venture capital. Analytics is the next logical step—[look at how] healthcare providers have been incentivized by the federal government to adopt medical records. [But what happens] after implementation of the electronic medical health record? Besides the value to regulators and payers, what is the real clinical value of all this data we’re collecting? People are recognizing not only that it’s important to know what kind of data we’re collecting but how we’re going to use to make an improvement in quality, safety, affordability, and so on.

 

What you do with this treasure trove [of information.]

 

Rather, what’s legal to do? What’s the community standard of care? These kinds of questions require physicians to be much more proactive, to get involved.

 

Healthcare systems are under a lot of pressure as we move to value-based care. Do you have any advice as they try to bring innovation to their system?

 

There are a couple of different aspects to that. One is how they innovate in general. Many healthcare systems are just starting to address it. The position of chief information officer is just starting to take off. But how do you actually innovate in healthcare? It’s going to be different for every organization. So the question is: What are their priorities? Is it safety, quality, affordability, patient satisfaction or a combination thereof? Where are they lacking; where [do] they need to address things? A good place to start is to look at their “portfolio of problems” that cannot be solved today—problems that they totally understand, not a use case that they don’t understand. From there they go on to things that are more into the future.

 

I find this balance between risk and reward when I’m talking to a healthcare system. They’re afraid of taking on much risk but they know, like every industry, they’re going to have to do something because of the transition. What about the medical entrepreneur who wants to work with the healthcare system?

 

Our group saw an evolution over time from the less successful to the more successful entrepreneurs. The early entrepreneurs were essentially technologists with no healthcare expertise. It was interesting for a healthcare provider to look at [what they had] but they couldn’t make any sense of it. Neither could they find the questions the entrepreneurs needed to be answered. As time went by, entrepreneurs started to come in with what they considered evidence. That’s the first question that health care providers always ask. [So] for heath care entrepreneurs it’s important to have evidence; it’s important to address an existing use case and not a fantasy use case. If you look at any study or any article that [notes] the CIO’s main priorities for 2017, you’ll find out very quickly what the top-of-mind concerns are and those are the concerns you need to address so that you can get in the door. Leaders of health care organizations are super busy, and unless you address something that is on their plate, they’re not really going to pay attention to you.

 

There is a kind of breakdown between the entrepreneur, who, as you’ve mentioned, is a technical person, and providers—nurses, physicians who might want to get involved in building out new businesses. Do you have suggestions for entrepreneurs [on] how to bring on providers, or for providers who might want to become entrepreneurial?

 

There are a couple of things I tell folks. One is to make it known what you want to do. Given our automation, our technology you’d think this would be more efficient but it’s still relationship driven. If you want to find a position that’s entrepreneurial; you want to get into a start-up; you want to start a start-up, you want to start connecting with investors. You need to go out there and shake hands. You need to go to conferences. You need to give talks about what you’re interested in, tell people what you want to do. For sure, manage a LinkedIn profile that makes sense for where you want to go because that’s one of the main tools for recruiters. These things are not hard but they take time. I hate to use the word but in a sense you need to market yourself. You need to make sure that the right people find you quickly. Because before you know it, things will change. The other [as a] physician is to prepare yourself so you can contribute to a startup. Many people don’t know what a startup really involves—the risk, the investment of time. It’s very different than a job and it’s not for everybody. For physicians, probably the best thing is to get in is when the startup has been already funded so that the situation is a little bit closer to what they’re used to.

 

Yan, I want to thank you very much for your thoughts today. You’re at the center of innovation and having had this broad experience, I would suggest to anyone who is listening that they can reach out to you on LinkedIn. Awesome to have the conversation.

 

Yes, nice to talk. I would be happy to connect with anybody who has any needs or wants to just discuss.

Conclusions

 

It’s interesting to see how everybody views innovation differently. But unless you can bring all those views—the equity markets, the provider network, the entrepreneur—together with a common view, it becomes really difficult to bring forward a solution.

 

TechTonics by David Shaywitz and Lisa Suennen is an interesting collection of essays on medical innovation.

 

Dr. Chow can be reached via LinkedIn

 

 

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