Thomas Vail MD on how UCSF Orthopedics Fosters a Culture of Innovation in Digital Health

February 26, 2018

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Check out the full video interview with Dr. Vail below

#DOCSF18 – Dr. Thomas Vail is the Chairman of the Department of Orthopedics at UCSF and the Former President of AAHKS. Dr. Vail and Breanna talk about how UCSF fosters a culture of digital health innovation throughout the orthopedics department.


Transcription

Breanna Cunningham: Hello, there. Bre Cunningham here with Code Technology at DOCSF, and I have the pleasure of interviewing yet again …

Dr. Thomas Vail: Thank you.

Breanna Cunningham: … the Dr. Vail. He is the Chair of the Orthopedic Department at University of San Francisco, and couldn’t think of a better subject matter to talk with applying practical things that we’re learning from this conference into day-to-day practice. Tell me about how your department goes about innovation and selecting … being early adopters of these new tech companies, but also making sure you get something that works.

Dr. Vail:
Well, I think you hit on the real issue here, and part of it is practical and part of it is aspirational. For our department, we really want to lead and take advantage of and participate with companies that are innovators in technology. We think there’s a huge opportunity in that arena to solve some of the most pressing problems that we face in patient care.

Now, that being said, as you alluded to, there are some real challenges associated with this process, because there’s a lot of innovation out there. There’s a challenge to determine what part of that world of innovation fits into what we’re trying to do. How do we spend our limited resources of time and dollars wisely? And how do we adopt a technology that’s not just something shiny and new but really, truly solves a problem? That’s what we’re looking for.

Now, just in terms of how do we organize, we’ve created a committee in our department of interested faculty members. It’s called the Health Information Technology Committee, and part of the charge of that committee is to evaluate new technology.

Breanna Cunningham:
Who all makes up that committee?

Dr. Vail:
There’s probably six or eight faculty members.

Breanna Cunningham:
Is there anyone from outside of your faculty? Other departments that come in? IT?

Dr. Vail:
No, they’re administrative people within the department. Stefano Bini, Aenor Sawyer, orthopedic surgeons with technology interest and background, and then others from various sites where we provide care: the VA, San Francisco General Hospital. They are providers of care, surgeons, staff that are interested in what I just articulated about incorporating technology into practice.

Breanna Cunningham:
Speaking of Dr. Bini and Dr. Sawyer, there’s a lot of people that are your faculty that are really thought leaders and innovators in the space. Do you think it’s because it’s in the Bay Area and there’s all this buzz, or it just random? What percentage of your providers are all about AI and coming to conferences like this?

Dr. Vail:
Well, absolutely not random. This is something that we’ve encouraged. I know when Stefano came onboard a couple years ago into the department, we had conversations around this interest, and I was enthusiastic about creating a mechanism to benefit from technology and cull through technology, as we were discussing. Aenor Sawyer came to the department with that expertise and interest.

I think there’s a part of a lot of surgeons and health care providers that’s interested in this topic, and I think if you have a platform to allow them to become more knowledgeable, participate in decision-making, and make it an active part of sort of the mission of the department, that you’ll get engagement. And that’s what we’ve seen in our own department.

Breanna Cunningham:
I love it. So does that mean that you’re going to start working with Topher and Under Armour on getting that data into health care providers’ hands?

Dr. Vail:
Well, yes. Maybe not specifically with Under Armour, but possibly. You never know.

Breanna Cunningham:
Were your wheels just spinning as he was talking?

Dr. Vail:
Yeah, absolutely, because you know, there were a couple of moments listening to him talk, listening to [Q 00:04:14] talk about information, and a lot of the conversation today is about gathering information from multiple sources that allows us to make informed decisions at the point of care. And I think Q made the observation that a lot of the information that’s available through standard electronic health record is, you know, that episodic visit to the doctor, without a lot of knowledge about what happens in between, and without a lot of focus on what’s important to patients.

Now, if you listened to Topher’s presentation, what was clear is that his company, Under Armour, is very tuned in to what patients want, what’s important to patients, and they’re measuring things that are important to patients.

Breanna Cunningham:
Athletes. They are patients, too.

Dr. Vail:
Yeah, excuse me. You’re right. You see my focus. It’s athletes. In their case athletes, for us patients. Let’s just say
people.

Breanna Cunningham:
People, exactly.

Dr. Vail:
Right, important to people. So that information that they’re collecting from their athletes, from the people who wear their products, could be very relevant to their health status and health decisions they might make. So yeah, very interesting, very useful to us. This whole sensor technology, I think, in various capacities-

Breanna Cunningham:
The embeddables?

Dr. Vail:
Embeddables. Wearables.

Breanna Cunningham:
I loved him term of “frictionless”, right? Frictionless solutions. How do you make sure that people can be engage and involved? I think … I don’t know for sure … but my chart, engagement’s like 10%, and their engagement for their people is so high. So it’s inspiring. I think we can get there, yeah? Health care can get there.

Dr. Vail:
That kind of thing is easy. It’s part of their clothing. It’s passive. It doesn’t require remembering your password, logging on, all the onerous things that go with a traditional My Chart-type of an interaction. This is really measuring people in their own environment, and that is probably the most important information that we could have about their health.

Breanna Cunningham:
So from the sessions that you heard this morning, what’s the one thing that you’re going to take back to your department, share with the team?

Dr. Vail:
Wow.

Breanna Cunningham:
The panelists were amazing. There was so much amazing information that was both philosophical but then also practical.

Dr. Vail:
Yeah, I think philosophical is right. I think what I take away from this conference is an awareness of a lot of the areas of focus, at least in what we concentrated on today, the artificial intelligence, the machine learning. What are the opportunities in those areas? What are the young companies that are developing innovating technologies thinking about? What’s critical for their success? How does that match up with our needs? I think those are the aspects that are most important.

I’ll say at the same time, there are a lot of questions that are raised. You know, when you start to talk about machine learning and artificial intelligence. Again, Q from IBM brought up this idea of what information sources do you use? You can not only analyze, but you can select the sources from which you gather data. That brings up some interesting questions about bias and what the information sources might tell you, depending upon what you select as your base of information.

Breanna Cunningham:
As your source of truth, right?

Dr. Vail:
Yeah, so I think there’s an increased understanding about the meaning of these terms that we toss around a lot, that are kind of buzzwords that are interesting and intriguing, and I think we all feel like there’s a sense of opportunity to use these in some way to benefit patients and health care. But what do they really mean, and what are the nuances? That’s what you get out of a meeting like this.

Breanna Cunningham:
It sounds like UCSF is really driving that too, so, exciting. I look forward to interviewing you next year and hearing all the amazing stories about how this technology’s been applied.

Dr. Vail:
Good. I hope. We’ll keep trying.

Breanna Cunningham:
Dr. Vail, thank you. Enjoy the rest of your conference.

Dr. Vail:
Thank you.