Stanford Health Care is the adult healthcare system within Stanford Medicine, an academic medical center that combines clinical care, biomedical research and clinician training. Based in California, it provides specialised, quaternary care across areas including cancer, cardiovascular medicine, neuroscience and transplantation, while working closely with the Stanford School of Medicine on research and innovation.
You've led major academic health systems in Utah, Wisconsin and now Stanford. What has changed most about healthcare leadership over the course of your career?
The biggest change has been transparency and the ability to use data. We've collected data for a long time, but when I started nearly 30 years ago, we didn't even share quality data. Finance data stayed internal too. As technologies evolved, we've become much better at getting information back out in a way people can actually use.
Clinical science has obviously advanced in areas like oncology and cardiology, but from an industry standpoint, the ability to use data has been the most transformative change. Today we're able to use it for research, summarise information for patients, enable clinicians and, increasingly, use it in entirely new ways.
Stanford recently announced a major new cancer centre in Redwood City, California. What will it enable that existing facilities weren't designed for?
Oncology has made incredible strides. Cancers that were once death sentences are now conditions people can live with and have healthy lives. At the same time, our cancer patient volumes doubled over the last 10 years, so part of this investment is simply meeting growing demand.
The exciting part is that this center will combine discovery, research and patient care in one place. It will include technologies such as tumour-infiltrating lymphocyte treatments and advances in stem cell, gene and immunotherapies, adding to innovations like our new, first-of-its-kind ultracompact proton therapy facility. It's a big commitment. But what we'll be able to do for patients locally, regionally and nationally will be incredible.
Where are you seeing the most exciting innovations in healthcare today?
What excites me most is not just generative AI but agentic AI — the ability to think, understand and act. We can all be Dr. Google now, and generative AI can provide enormous amounts of information. What's different is the ability to act on that information and bring the latest research directly into clinical care.
At Stanford we've developed ChatEHR, which allows physicians to query entire patient records using multiple large language models. Physicians can ask questions of vast patient charts and uncover insights that would be impossible to find during a typical appointment. We've already identified diagnoses that weren't previously recognised. We can also automate tasks that once took hours, from determining eligibility for off-site care programmes to matching patients with clinical trials in real time.
How does Stanford translate discoveries into treatments, and how do you decide which innovations to prioritise?
Clinical trials are where discoveries move from bench to bedside. Whether it's tumour-infiltrating lymphocytes, B-cell depletion research or other emerging therapies, the goal is to take scientific discoveries and turn them into treatments that can genuinely change outcomes. That's why patients come from around the world to Stanford.
The challenge is prioritisation because there are a thousand flowers blooming. We receive more than 100 ideas a year through Stanford Medicine Catalyst, our flagship innovation accelerator, and we can't pursue everything. What helps is bringing together the schools, researchers and clinical enterprise under a shared strategy. That alignment allows us to decide where resources will have the greatest impact. Right now, oncology and neurosciences are particularly exciting areas, especially work around degenerative neurological diseases and implanted devices that allow patients to communicate.
How do you balance cutting-edge innovation with affordability and accessibility for patients?
Cost is one of the biggest challenges we face, particularly in one of the most expensive regions in the world. We have to be judicious about what technologies we bring in and carefully balance innovation against affordability.
With AI, for example, we've had to ask whether the investment generates savings or efficiencies elsewhere. The return on investment wasn't always obvious at first, but we're beginning to see meaningful benefits, particularly in back-office operations. The challenge is bringing in technology while still keeping healthcare affordable.
Stanford has a long history of medical breakthroughs. What makes that culture of innovation possible?
Think about what it took for Norm Shumway to perform the first adult heart transplant in the US, which happened here at Stanford in 1968. That willingness to push boundaries still exists today.
A recent example is Dr Joseph Woo's work on a new heart transplant technique that keeps a donor heart beating and supplied with blood during transport and implantation, rather than placing it in cold storage. More broadly, Stanford creates an environment where engineering, chemistry and medicine naturally work together. This has probably been the best university where I've seen the engineering department work with the chemistry department, get together with the School of Medicine, and they actually do that naturally. That ecosystem continues to attract people who thrive on discovery.
How are patient expectations changing, and what still feels outdated about healthcare today?
Patients now expect immediate access. They expect online scheduling, rapid appointments and instant information. They arrive having researched their conditions and often with strong views about treatments and technologies. As consumers, we're used to having information at our fingertips, and those expectations naturally carry over into healthcare.
What feels most outdated is billing and collections. The way we bill and collect would be so much different if we started from the ground up. The referrals, pre-authorisations and administrative back-and-forth remain cumbersome for providers, insurers and patients alike. Despite all our technology, much of healthcare is still highly manual. About 60% of health system costs in the US are labour, and while many aspects of care will always require people, there's significant opportunity to make processes more efficient through technology, freeing more time for our people to focus on meaningful interactions with patients.
