This week, we interviewed Ryan Ribeira, CEO at SIMX VR, Emergency Physician, and Assistant Professor at Stanford’s School of Medicine. He’s previously served on the board of trustees for the American Medical Association and as a program manager for health products at Google. Ribeira was able to give a unique perspective on healthcare technology, the advent of VR in healthcare, and other pain points in successful care delivery and patient outcomes.

What trends do you think of when you think about streamlining the patient's journey through today's hospital system and delivering better outcomes?

"Obviously that's a pretty big question, but I think there are a few particular parts of the patient journey that are ripe for streamlining.

I think the first thing that the healthcare system needs to recognize is the patient's journey doesn't start when they enter your hospital: it starts when they start to realize that something is a bit perhaps abnormal with their own health and maybe they should start looking into it. Historically, our healthcare system has been designed such that patients need to make some very challenging decisions completely on their own. Patients have to figure out: is this even a problem? Is this abnormal? If it is– do I need to go to an emergency department? Do I need to go to a clinic? These can be challenging things to figure out, even for an experienced physician. And so it's unfortunate that we leave patients to their own devices in this, especially in the US healthcare system where sometimes the financial implications of making the wrong decision are pretty substantial.

So one of the ways we could make that journey easier for patients is by putting more and more resources into the contemplation phase of the patient journey. This could be through static online information, A.I. enabled online tools, or physicians who do phone or video triage systems. This way we won't leave anyone out to dry and we ensure all patients are getting the care that they need at the right time in the right place."

You're the CEO of SIM X, which is a VR company that helps hospitals go through simulation processes. Tell me a little bit more about SIM X what your mission is?

"At SIM X we make virtual reality medical simulation software. So instead of having a plastic mannequin or something in front of you that you're running your simulations around, instead doctors put on a headset and interact with a virtual patient. You can talk to him, stethoscope and ultrasound him, and diagnose and treat the medical problems just like you would in real life. Taking this VR technology and bring it into the simulation environment means that your patient can be a lot more realistic: they can be are age, be vomiting, or missing limbs, or even emote. You can even replicate the experience of treating two patients or more simultaneously, creating the chaos of a busy trauma bay.

Really the most challenging part of actual medical practice is not just remembering your medicine, it's being able to practice your medicine while you are caring for the psychosocial needs of your patients and their families. That's one of the most powerful things that we're able to do with VR, and we can now do it cheaper and faster than ever before."

Let's talk about shifts for a second, because clearly we're in unprecedented times right now. What changes to the healthcare industry at large do you think will persist after the COVID-19 pandemic?

"I think there are definitely some things that are going to persist, chief among them being the proliferation of telemedicine. We've seen telemedicine just explode over the last few months: here at Stanford it's used now by essentially every clinic. We've even been launching emergency medicine based telemedicine programs. It really is a very convenient way, both for the providers and the patients, to be able to connect kind of on their own terms and in ways that don't have all the logistical challenges of physically traveling to offices. We're going to see telemedicine become a bigger and bigger part of our healthcare system.

We're going to see more of a recognition that a big part of the patient's journey happens outside of the walls of our hospitals. I think you are going to see health care systems have more of a focus on how to address patients' needs at home, both before and after they've interacted in person with our health care system.

Secondly, we're going to see more of a recognition that a big part of the patient's journey happens outside of the walls of our hospitals. I think you are going to see health care systems have more of a focus on how to address patients' needs at home, both before and after they've interacted in person with our health care system. And I think that can only be a good thing. Overall, we need to start shifting focus and not think of our health care system as centered around the hospital, but centered around the patient and their data.

When you come into the emergency department and get a huge bill, it's not because the time and crutches we give patients are more expensive. The high cost of care is because of the enormous overhead costs necessary to keep a hospital running and prepared for a disaster at any moment. This is a very expensive place to deliver care. And for the overall system, it's certainly better if we can keep those doors open to provide care for the people who absolutely need it, but take care of those who don't in a place that’s more appropriate for their needs."

You were talking about the importance of telemedicine. How do you build a personal relationship with your doctor if everything is happening via computer?

"I think 30 years ago, everyone would have kind of been aghast at the idea of developing a relationship without having met in person. But I think trends in society overall are leading us towards a place where you can absolutely do that: people are developing long term friendships and romantic relationships on the internet. We are finding ways as a society to develop personal relationships without in-person contact. And it's never going to be quite the same.

However, I don't think that it needs to serve as a wholesale replacement for in-person contact. There's always going to be a place to actually come in and see your doctor face to face when you need it."

In talking about day-to-day healthcare, where do you see the main points of friction when it comes to delivering great patient care?

"Frankly, a lot of friction in delivering good patient care actually comes from regulatory requirements from the government or insurance companies around documentation. You'll hear a lot of physicians talk about the amount of time that they spend sitting in front of a computer rather than talking to patients. It ends up being something like 60 percent of your actual on-shift time is at the computer servicing documentation needs. And so that has grown to become a huge barrier between physicians and patients. That's part of why, when you go to the E.D., you'll see your doctor for five minutes in three little sessions over the course of it. It's because that documentation burden has become really tremendous. And I think that's really unfortunate."

To listen to the full interview, listen to The Patient's Journey below on Apple Podcasts:

‎The Patient's Journey on Apple Podcasts

‎Health & Fitness · 2020