UVA Health is a statewide academic health system providing specialized care to patients from across Virginia and the surrounding region while also supporting community healthcare needs through a broader network of services. The health system combines patient care, medical research and education through its hospitals, specialty centres and partnerships with other health systems across Virginia.
You've spent many years at UVA, both as Chair of Medicine and now leading UVA Health. What has changed most about academic medicine during that time?
An academic health centre is a unique place where you integrate patient care, research and education on one platform. Over time, it's become more challenging. It used to be that the clinical enterprise could more easily support research and education, but as margins have become compressed, there's greater pressure on that model.
At the same time, what's exciting is the intersection of all three. Advances in AI, cellular therapies and molecular medicine are transforming our ability to connect research and clinical care. Discoveries are reaching the bedside much faster and curing diseases we previously had no solutions for. Education is changing too. We need to teach students how to use these advanced tools while still emphasising the human side of medicine. Patients still want that human touch, and we can't lose sight of that.
UVA Health has been doing significant work around AI. Where are you seeing the biggest impact on patient care today, and how could it change cancer treatment?
I see four major areas. First, AI is a clinical support tool that helps clinicians make faster, more informed decisions, reduces administrative burden and helps identify therapies tailored to individual patients using electronic medical records and genomic data. It also improves workflows and allows clinicians to spend more time with patients.
Second, we're seeing benefits in imaging and predictive diagnostics. In brain tumours, for example, AI can help distinguish disease progression from treatment effects by identifying subtle imaging features. That allows us to understand more quickly whether a patient is responding to therapy. If they are, we continue treatment; if not, we can switch sooner to something more effective. We're also using AI to predict hospital length of stay, support transitions home, improve home-based care and better understand how drugs behave in individual patients based on biomarkers and genomics.
Hospitals are investing heavily in robotics and AI. Will these technologies also help address clinician burnout?
Robotic platforms are now being used across a much wider range of procedures, including cancer surgery, thoracic surgery and increasingly cardiac valve and coronary surgery. The goal is to reduce complications, shorten recovery times and get patients home sooner. Looking ahead, integrating robotics with advanced imaging and AI for areas such as tumour care and neurovascular care is particularly exciting. We're only at the beginning of that journey.
As for burnout, I think it's a bigger issue than technology alone. AI can certainly reduce administrative burdens and documentation requirements, but it can also contribute to burnout if it's not thoughtfully integrated. Clinicians want autonomy and control over their work. If AI becomes another layer imposed on them, it could make things worse. That's why we focus on tools such as ambient listening, automated chart summaries and AI-supported telemedicine workflows that are designed to make clinicians' lives easier, not harder.
UVA Health is expanding emergency and inpatient capacity at a time when more care is moving outpatient. What is driving that decision, and where do you see future demand?
We're in a unique position as a large tertiary and quaternary care centre serving a very large catchment area. Our hospital is full, or beyond full, almost every day. We want to be there for patients facing the most difficult and complex problems, and to do that we need both a strong ambulatory network and continued investment in inpatient capacity.
Looking ahead, demand will likely be driven by neuroscience, cancer care, transplantation, advanced cardiac programmes and rare disease treatment. We're also building the UVA Paul and Diane Manning Institute of Biotechnology, a 350,000-square-foot facility designed to bring together researchers, clinicians, entrepreneurs and innovators so that discoveries can move from the laboratory to the bedside much faster. Combined with our expanding clinical capacity, we believe that can lead to transformational care.
UVA Health is known for highly specialised care. How do you balance those ambitions with the broader healthcare needs of your community?
That's something we wrestle with every day. Historically, most of our admissions came from transfers for highly specialised procedures. Today, many admissions come through the emergency department with lower-acuity conditions. We still want to be there for patients with the most complex problems, but we also have an obligation as a community hospital to care for everyone who comes to us.
Our strategy is to build alternative care models. Hospital-at-home programmes, remote monitoring and other lower-cost settings can provide excellent care without requiring admission to a tertiary care hospital. With heart failure patients, for example, remote monitoring allows us to detect small changes in weight or vital signs early. A simple intervention can prevent a crisis that might otherwise result in an ambulance ride and hospital admission.
How do you decide which innovations are worth pursuing, particularly in a constrained financial environment?
We've created a Technology Council that looks at innovation from three perspectives. The first is supporting our own faculty through grants and internal incubator-style programmes that help develop new ideas. The second is evaluating external products and determining which technologies are worth bringing into our ecosystem and testing safely.
The third is developing broader corporate partnerships. We want to understand whether strategic relationships with major companies can help us access and evaluate new technologies more effectively. Those three approaches help us assess a rapidly changing landscape and determine which innovations are most likely to benefit patients and the health system.
What developments at UVA Health are you most excited about, and what still needs to improve in healthcare?
The project I'm most excited about is the UVA Paul and Diane Manning Institute of Biotechnology. It represents a significant opportunity to accelerate life-changing therapies by bringing together researchers, clinicians, entrepreneurs, industry partners and others to make discoveries more accessible to patients. One of our goals is not only to develop therapies more quickly but also to ensure they remain accessible as costs continue to rise.
At the same time, I think hospitals still have significant room for improvement. One area I've become increasingly interested in is the patient experience. Hospitals are often noisy, chaotic environments that don't always support healing. We need to spend more time thinking about what a truly therapeutic environment looks like. If you compare the hospital experience with what people expect elsewhere, there is still a great deal that can be improved—not just in service, but in creating spaces that genuinely help people feel better and recover.
