“Dr. Kim” is super duper smart. Sometimes intimidatingly (physician, Chief Innovation Officer for Kaiser Permanente SF Medical Center, etc). Fortunately she’s also very nice. We met via mutual grad school friends and our families hang out (she’s got two rocking daughters and an entrepreneur husband). My favorite “Five Questions” interviews focus on people who have one foot in the tech world and one foot elsewhere.
Hunter Walk: From a doctor’s perspective, how is technology changing pediatrics – what technology — medical-related or more general – do you use in your daily practice that might not have been part of a doctor’s life 10 years ago?
Dr. Kim Newell Green: There are so many exciting technologies that are impacting my day to day care but the elephant in the room is the electronic medical record (EMR). Robert Wachter’s wonderful and very readable deep dive into the impact of technology on medicine and doctoring,“The Digital Doctor”, highlighted a fact that I had felt but not been able to fully articulate: with any large technological advancement, the promise of saving time and money is made at the outset. However, that promise is not realized immediately, and in fact for 10-15 years the industry is made less efficient and more costly.
Such is the case with the EMR now: electronic medical records cost money for practices, hospitals and health plans that are being asked to cut costs, and have lengthened the physician’s days significantly, in doing so taking time away from the “bedside,” from the patient. It’s an awkward and frustrating moment in this cycle and we all look forward to the day when these technologies will save money for health care consumers and providers, and will make care more efficient, giving time back to the doctor-patient relationship.
HW: Patients can also access much more medical information and community. Is this a mixed bag – on one hand you get more informed and involved parents, but it’s easy to find incorrect information or apply the right info in a wrong manner?
KN: It is true that many of the most anxious calls I field come after a patient or parent has asked “Dr Google” about their symptoms. In general, however, I’m extremely grateful for the easy accessibility of medical information and for the community that engaged and connected patients can leverage to help them navigate their health care. With the enormous amount of knowledge about medicine and health these days, no physician can know a single disease or condition as well as an informed patient can.
Patients do best when they become researchers and advocates for their own health. Sometimes people do overestimate their ability to make decisions without a “real” doctor. I think that there is now and will always be a role for an informed and wise clinician to help patients navigate their care and check their own ideas and plans.
HW: One of your roles is Chief Innovation Officer at the Kaiser Permanente San Francisco Medical Center. What does this mean from a tech & health care perspective? As an institution, how does KP view startups and their openness towards working with them?
KN: Kaiser Permanente is an enormous organization that is at the forefront of delivering the highest quality healthcare and leverages many advanced technologies in order to do so. In the rapidly-changing healthcare environment, all healthcare organizations need to balance the need for stability and reliability with the need to be nimble and make thoughtful change to meet and exceed our patients’ needs and hopes.
As such, I have been asked to lead an initiative at our local medical center in San Francisco to develop the people, tools and processes to pilot new ideas around providing even better healthcare, whether through technology or changes in workflows, systems, or processes. As all large organizations know, innovation is sometimes felt to be in conflict with day to day operations, but but by working thoughtfully with engaged teams who have been involved in the ideation process early, we are doing exciting work.
As an organization, Kaiser Permanente looks closely at new ideas in healthcare through many lens and in many parts of the organization. For example, our Garfield Innovation Center follows trends and works with startups regularly and has a pulse on the cutting edge of medical care, helping to evaluate new technologies and move them into our organization when they meet a need for our patients and our organization.
HW: Are there mistakes that you see healthcare related startups commonly make when they seek to partner with doctors and hospitals?
There are so many wonderful ideas in medicine today, and innumerable problems that will be solved with technology. In today’s economic climate, however, the ideas that will fly must create cost-savings. Many of the startups that I have spoken with have not taken this into consideration. Many of the digital health startups that I see have also begun to talk to doctors and healthcare providers very late in their development process. By getting health care providers involved early and deeply, they are more likely produce solutions that will move the needle in improving patient outcomes and helping decreased healthcare costs.
HW: You have two daughters below the age of 10. What’s been your philosophy with regards to “screentime” and their use of tech?
KN: The body of good scientific evidence on how “screentime” in its many manifestations impacts the developing brain is evolving. Until we have a more robust body of evidence, I try to follow conservative guidelines and find those from the American Academy of Pediatrics to be helpful: no screen time before the age of 2 and after that less than 1 hour a day or two hours on weekends. In fact, we “use” screens much less than this in our family, and our girls have had much less exposure to media that the guidelines suggest. All rules, however, go out the window on long car trips or airplane trips: in these settings I’m very grateful for the addictive nature of devices with screens.
As important if not more than the recommendations about quantity, however, is the quality of the media and technology experience. A good rule of thumb especially for young children is that the pace of the show or activity should be that of real-life: think “Mr Rogers”. Extremely fast-paced shows seem to have negative effects on growing brains. And as a family we think it’s important to avoid violence, and to be particularly watchful for the representations of girls in media: young cartoon characters and girl actors are increasingly presented in a very “sexy” way and we like to limit exposure to these images. Commonsensemedia.org is a great resource for good programming.