Speaker 1: You're listening to Bloomberg Business Week with Carol Masser and
Speaker 1: Jason Kelly on Bloomberg Radio. Certainly, what's on investors minds
Speaker 1: and again many around the country is the increased numbers
Speaker 1: in virus cases and hospitalizations. And there's a lot of stories.
Speaker 1: If you look at the most right on the Bloomberg
Speaker 1: almost all of the top ten have something to do
Speaker 1: with the virus. So let's get into it and talk
Speaker 1: about the virus how the health community is continuing to
Speaker 1: deal with it. Lloyd Minor is a scientist, surgeon, and
Speaker 1: academic leader. He's also dean of the Stanford University School
Speaker 1: of Medicine. It's a position he has held since December.
Speaker 1: Also with us is David Entwistle, presiden CEO of Stanford Healthcare,
Speaker 1: which in November opened its new eight hundred twenty four
Speaker 1: thousand square foot state of the art hospital. It's total
Speaker 1: bedcount is now six oh five, total operating rooms to
Speaker 1: eight seven, so a huge facility. Both joining us on
Speaker 1: the phone from Stanford, California, gentlemen, so nice to have
Speaker 1: you here with us. So I gotta just ask you first,
Speaker 1: because of the virus surges, should some states and cities
Speaker 1: be considering slowing or reversing reopening plans. And Dr Minod
Speaker 1: let me start with you. How do you see it?
Speaker 1: Thank you very much, it's good to be with you today. Certainly,
Speaker 1: we are seeing an increase in the number of COVID
Speaker 1: cases in many cities and locations across the United States,
Speaker 1: and I think that indicates that we need to continue
Speaker 1: to observe social distancing. The masking guidelines that have been
Speaker 1: rolled out in many communities. There's good evidence that masking
Speaker 1: helps to prevent the infection. It's gonna be I think
Speaker 1: a location by location decision as to what additional measures
Speaker 1: are put in place. That is, whether or not we
Speaker 1: roll back from stage two where many places are today
Speaker 1: to earlier stages. But the main thing is we've we've
Speaker 1: got to be more prudent about UM as we resume activities,
Speaker 1: as businesses, restaurants, uh, department stores start to open. We've
Speaker 1: got to observe social distancing, we've got to use mass
Speaker 1: um and do things that less than the spread of
Speaker 1: the infection. Well and David, largely because all of this
Speaker 1: comes down to or so much of this comes down
Speaker 1: to essentially hospital capacity, So help us understand from the
Speaker 1: perspective of someone running a hospital, what you worry about
Speaker 1: with this spike and what hospitals like yours are doing.
Speaker 1: And obviously you're not facing at the moment any sort
Speaker 1: of surge, But in your shoes or in the shoes
Speaker 1: of others running hospitals, what are they thinking about. Well, no,
Speaker 1: I appreciate that opportunity. One of the things that we
Speaker 1: wanted to do, and certainly with any slowdown, which we
Speaker 1: did as the initial pandemic came on, as we started
Speaker 1: to see the numbers diffendit, what we were most concerned
Speaker 1: about then is getting some of the folks back into
Speaker 1: the queue that actually needed some of the delayed surgeries
Speaker 1: and other things that were going on. We started with,
Speaker 1: which I think is a bit of a model, building
Speaker 1: on what Dean Miner said, actually doing testing, so making
Speaker 1: sure that the population that we had within the hospital itself,
Speaker 1: our employees, our physicians, uh that we were free of
Speaker 1: the virus. And we actually tested over twelve thou employees
Speaker 1: and staff and saw less than a point three percent
Speaker 1: of those staff actually had the virus, And so we
Speaker 1: knew that we were creating a safe environment. But I
Speaker 1: think it's important. Despite being able to be there and
Speaker 1: be a resource for the community, we do also have
Speaker 1: to have capacity. And one of the things that we've done,
Speaker 1: despite opening back up doing our elective surgeries, is creating
Speaker 1: still a capacity within the organization that's there and always available,
Speaker 1: because that really is the concern is if we get
Speaker 1: another significant spike, well, we have the capacity to be
Speaker 1: able to treat and we want to make sure that
Speaker 1: we're ready for that this time without having to shut
Speaker 1: everything down. Well, Dean Minor, you know what have we learned?
Speaker 1: You know, here we are, Jason and I have been
Speaker 1: working from home essentially. Jason went into the office a
Speaker 1: little bit this week, but he's back home. But here
Speaker 1: we are, and I think week fourteen, week fifteen, Um,
Speaker 1: what have we learned from the medical perspective about how
Speaker 1: to treat with the how to treat the virus, how
Speaker 1: to stay ahead of it, how to watch for either
Speaker 1: another spike? I mean, tell us what we've learned? Thank you.
Speaker 1: I think we've learned several things. First is that this
Speaker 1: is a respiratory virus. The principal mode of transmission is
Speaker 1: from one person to the next through secretions through mucus,
Speaker 1: through a cough, um and and there may be other
Speaker 1: modes of transmission as well, but the main danger is
Speaker 1: through direct contact with secretions of someone who is infected,
Speaker 1: and it is a highly infectious virus. We've certainly improved
Speaker 1: our ability to treat people who become ill in the
Speaker 1: hospital our own hospital, Stanford Hospital UH we have been
Speaker 1: a pioneer in the studies of brindissevere that has been
Speaker 1: shown to be effective and in improving the recovery rate
Speaker 1: uh and and perhaps also in lowering the risk of
Speaker 1: mortality from the virus. We've been a part of those studies.
Speaker 1: We now have studies going on in the outpatient setting
Speaker 1: using anti virals at the time someone is diagnosed with
Speaker 1: the infection, before they become severely ill, using antivirals in
Speaker 1: a clinical trial setting in order to determine if there
Speaker 1: are therapies we can give to outpatients that reduce the
Speaker 1: severity of the disease and reduce the likelihood that people
Speaker 1: will need to be admitted to the hospital. We know
Speaker 1: that the tragedy in New York and in other places
Speaker 1: where hospitals and health healthcare delivery systems became overwhelmed. The
Speaker 1: tragedy was that we as health care professionals, were not
Speaker 1: able to provide the care we're capable of providing to
Speaker 1: patients who come to us because our facilities were overwhelmed.
Speaker 1: As long as we're not overwhelmed, as long as we're
Speaker 1: able to provide the type of high quality, intensive care
Speaker 1: that our hospital and so many others across the country
Speaker 1: are able to provide, As long as we don't become overwhelmed,
Speaker 1: I think we'll be able to take care of people
Speaker 1: throughout the course of this pandemic. But it's important to
Speaker 1: remember this is a serious infection in many people. Um
Speaker 1: in young people it tends to be less severe, but
Speaker 1: in older people or people who have underlying medical conditions
Speaker 1: like high blood pressure, diabetes, the infection can be very seriously.
Speaker 1: So we have to continue to take it seriously and
Speaker 1: to respond accordingly. So, David, it feels like as a
Speaker 1: society we're faced with a few big moments right here.
Speaker 1: You know, we're faced with this moment around racial justice,
Speaker 1: and we're talking a lot about that every day on
Speaker 1: this program, and I'm sure you guys are talking about
Speaker 1: it as well. It also seems like a moment where
Speaker 1: we are thinking about healthcare very pun intended holistically and
Speaker 1: really rethinking it in terms of if we were to
Speaker 1: sort of design this from the ground up, how can
Speaker 1: we create a healthier community? How can we create a
Speaker 1: healthier society Because we're going to be living with things
Speaker 1: like COVID nineteen for a long time, you have the
Speaker 1: responsibility of building a health care system in that image,
Speaker 1: how do you do it for everyone? Because equality is
Speaker 1: one of those big big topics right now. Obviously well,
Speaker 1: and I'm granting brought inequality because we know that there's
Speaker 1: disparities in the way that health is delivered, and we
Speaker 1: know that there's more that needs to be done and
Speaker 1: that perspective, and that's something certainly we're working on here
Speaker 1: at Stanford. There's a lot in that question that you
Speaker 1: just ask. I have to say because if you think
Speaker 1: about um, we have been trying for years to think
Speaker 1: about population health. How do we take care of populations?
Speaker 1: If we were doing this right, we hopefully we'll keep
Speaker 1: them out of the hospital to begin with, because we'll
Speaker 1: be able to keep them healthy and keep them in
Speaker 1: a venue where they won't need to come here. Oftentimes,
Speaker 1: within hospitals, we think about the care that we deliver
Speaker 1: is when there's a failure and when they need to
Speaker 1: receive treatment beyond what their own health will sustain. I
Speaker 1: think we have some real opportunities with this pandemic, which
Speaker 1: is certainly the first in my lifetime and I hope
Speaker 1: the last. But I think as we rethink the way
Speaker 1: that we deliver healthcare, one is that we are we
Speaker 1: actually have individual stewardship and responsibility for our own healthcare,
Speaker 1: and I hope that we're taking advantage of those opportunities.
Speaker 1: But at the same time, we can re envision the
Speaker 1: way that we provide care. And I'll just give you
Speaker 1: one example that I know you've heard of before, but
Speaker 1: it's transitioned here at Stanford, and that's just the use
Speaker 1: of our digital technology both to look at data in
Speaker 1: predictive ways, but also digital technology in the way that
Speaker 1: we provide the care and a lot of times being
Speaker 1: able to provide care to individuals at a place that's
Speaker 1: comfortable for them and also avoiding, you know, having to
Speaker 1: go out and have in this case, potential access to
Speaker 1: other parts of the virus. And so there's so many
Speaker 1: things that I think that we can do now to
Speaker 1: re envision the way that is we're using digital technology internally,
Speaker 1: both predictive modeling, but also telehealth. One quick example, we've
Speaker 1: gone from roughly two and we do a couple million
Speaker 1: clinic visits a year, two percent of those being done digitally,
Speaker 1: two at the height of the pandemic, those being delivered vidually.
Speaker 1: And so think about how we can not only mitigate
Speaker 1: some of the cost of health care but also be
Speaker 1: able to provide care to individuals at their own sites.
Speaker 1: And so there's so much that we can do and
Speaker 1: think about, but certainly data will have a big place
Speaker 1: in that. We want to use that data to actually
Speaker 1: drive our decisions. And I have to say to both
Speaker 1: of you, you know, Jason and I have spent a
Speaker 1: lot of time at Stanford UM. We've done several broadcasts
Speaker 1: for TV and radio at the Business School. You know,
Speaker 1: you guys are smack in the middle of so much
Speaker 1: innovation in terms of Silicon Valley and just the conversations
Speaker 1: about kind of where does the world go? Always forward looking?
Speaker 1: So dr My, I do wonder. I do feel like
Speaker 1: the medical community, and maybe not yours specifically, but just overall,
Speaker 1: has been slower to innovate. I think it's a hard
Speaker 1: it's a hard beast to move right, So what will
Speaker 1: be kind of the innovative trends that maybe come out
Speaker 1: of the virus and then just others that are going
Speaker 1: to come in the future that really will be part
Speaker 1: of the medical world. Well, I'm please you brought it up,
Speaker 1: because if we look at the digital transformation of of
Speaker 1: our lives, every sector of society and of the economy
Speaker 1: has been radically transformed by digital technologies, except for healthcare.
Speaker 1: I mean, think about the way we order goods and services,
Speaker 1: the way we perform financial transactions. They're radically different than
Speaker 1: they worked ten years ago. And yet healthcare, at least
Speaker 1: prior to four months ago, um, we were still using
Speaker 1: fax machines and still calling up on the phone to
Speaker 1: make an appointment in far too many cases. David mentioned
Speaker 1: this transformation that we've seen over an incredibly fast period
Speaker 1: of time towards telehealth, and I really have to do
Speaker 1: a big shout out to our i T team here
Speaker 1: that very rapidly scaled up for the type of transformation
Speaker 1: that David described to have us do at one point
Speaker 1: of our visits is virtual online visits. We we should
Speaker 1: not lose the momentum that that we've had to obtain
Speaker 1: during this crisis, because there is so much more we
Speaker 1: can do leveraging technology, not in a way that separates
Speaker 1: us as healthcare providers from our patients, but in ways
Speaker 1: that connects us in more meaningful ways with our patients
Speaker 1: and also helps us to address some of the disparities
Speaker 1: that you brought up and that are so troubling to
Speaker 1: all of us. Yeah, it's a really important conversation right now,
Speaker 1: and I'm so glad Jason and I are both so
Speaker 1: glad that we had some time, um to catch up
Speaker 1: with both of you, and hopefully we can get to
Speaker 1: back soon again in the future. Dr Lloyd Minor, he's
Speaker 1: Dean of the Stanford University School of Medicine, joining us
Speaker 1: on the phone for Stanford, California. Although with David Entwistle,
Speaker 1: president and CEO at the Stanford Healthcare Uh, and I
Speaker 1: feel like, um, we could talk to them forever because
Speaker 1: with everything that's going on, Jason, and we're hearing lots
Speaker 1: of conversations we hear, you know, we talk with so
Speaker 1: many different members of the medical community. You know, everyone
Speaker 1: agrees it's been slow to change, um, but these guys,
Speaker 1: they're certainly involved in what's to come. It's also a
Speaker 1: reminder that there are multiple constituencies here, right, you know,
Speaker 1: we think about it just as patients and doctors, but
Speaker 1: it's much more complicated than that. And you alluded to
Speaker 1: that when you talk about slow to change, and you
Speaker 1: have the pharmaceutical industry, and you have the medical device industry,
Speaker 1: and you have you know, all these elements of it.
Speaker 1: There's an academic and research uh community embedded in there
Speaker 1: as well, so important to remember all those aspects. Yeah,
Speaker 1: and a reminder that I think we're going to see
Speaker 1: a lot more technology working alongside humans to better situations,
Speaker 1: especially when it comes to healthcare.