This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] today on Keynote,

Zafar Chaudry: (Intro) So I think the future of healthcare lies in the effective collaboration between the human and AI. So you can free up clinicians to focus on the uniquely human aspects of care.

I'm Drex DeFord, a recovering healthcare CIO and long time cyber advisor for some of the world's most innovative cybersecurity companies.

Now I'm president of Cyber and Risk. At This Week Health and the 229 Project, where we are dedicated to transforming healthcare one connection at a time. Our keynote show is designed to share conference level value with you every week. Now, let's get started with today's episode

Drex DeFord: (Main) Hey, Zafar, welcome to the show. Uh, You've become a bit of a luminary in healthcare technology. I feel like you're probably asked to speak at like every conference that is put on. You probably get some kind of a note to say, come and [00:01:00] speak. We love that you're part of the 229 project community.

Obviously there's good reason for all of that. So, how you doing? Welcome to the show.

Zafar Chaudry: Thanks for having me. Always. Uh, happy to chat.

Drex DeFord: I'm glad you're here too. Tell me a little bit about your background. You have an unusual background compared to a lot of other CIOs that are in healthcare and in children's healthcare.

So gimme the lay of the land. How'd you start? How did you wind up here? And some of the great jobs that you've been through on the way.

Zafar Chaudry: Yeah. So I started my career as a physician, and truth be told, the choices I was given by my parents was physician or dentist. And I thought maybe a physician will be better than looking in people's mouths all the time.

So I became a physician because culturally that's what my dad wanted me to be. But as I sort of transitioned from physician, had the opportunity in a hospital in Chicago to learn more about technology, and this was in [00:02:00] the early nineties, so that dates myself and I thought, well, this is a good thing if it gets me off some shifts.

So I got off some shifts and learned about technology and then realized this might actually be a thing way back then. But slowly eased and as people say, defected to the dark side, I became a technologist of worked in. Startups that went dot bomb, some startups that did go dot bomb.

And then went back to the UK sort of 2002. So I was in Chicago for about 12 years. Went back to the UK worked in the National Health Service for almost 12, 13 years. Got poached to Gartner. Gartner gave me the opportunity to work for different health systems, consult on projects around the globe.

Drex DeFord: How was the Gartner experience? You must have seen this. What I've sort of figured out sometimes is that when people go through Gartner, they get like 20 years worth of experience crushed into like, whatever, three years. It's so much

Zafar Chaudry: [00:03:00] exposure. It was about a three year journey for me, and it was very life changing.

Very high intensity. They train you on how to assimilate information very quickly, how to articulate it, how to present it, how to be that trusted source. Because remember, they're selling advice and how do you put a price on advice? So they really do hone you into somebody different. And I'm really glad I took that journey, but it was very high intensity.

Did almost a million miles on a plane and. Just over three years working in different regions with different governments, with different health systems, sort of became their in-house epic specialist. So I've seen a lot of things. One thing I've sort of seen in the journey is everybody says healthcare is different, but the way in which medicine is practiced is the same.

Different trade names, same generic names. But the funding. The funding of how healthcare is per region is different, but the actual care [00:04:00] of patients is the same, right? Physicians, nurses, allied health professionals, truly believe in the same thing. Taking care of the patient for the best outcomes doesn't really matter what country you are in, but it was a great journey.

Got to build some new projects, so did that, and then got headhunted back to the uk. To Cambridge where I was, the CIO for a couple of years. Primary goal to get Epic into the uk, fully baked and running. That was the first instance of Epic in the country. And whilst I was sorting that out, it was a combination of epic outsourcing to HP that needed to be so streamlined and resolved.

Did that then got headhunted over here to Seattle Children's. And I've been in I'd like to say sunny Seattle, but I've been in Seattle for, this is my eighth year. And truth be told, I interviewed here in, in June when it doesn't rain as much. Uhhuh, the changes have been that [00:05:00] difficult, but from a weather perspective, the same as the uk it's, it's wet, dull, gray. But we do have great summers and so I've been here, this is my eighth year. Working in pediatrics and I have worked in pediatrics before at the Children's hospital in Liverpool, so it wasn't something new to me. And it's a great job working in a mission-based organization that when you come to work you don't have to think about why you do the work.

'cause protecting kids and taking care of them is a very easy ask. So I really enjoy working here at Children's and. We're a well-known organization as you used to be here at Children's too. Drex. I did, yes. Once upon a time.

Drex DeFord: That's right. I have to tell me. So I'm just carrying

Zafar Chaudry: your torch forwards.

Drex DeFord: I think it's probably one of those things where I was there and there were a couple of CIOs in the interim and then you came and I think probably everything was really messed up when you showed up. 'cause that's how most most folks wind up getting their job. I'm with you. Seattle Children's is one of the best [00:06:00] jobs I ever had.

The mission is incredible. I tell this story all the time. Like you get onto an elevator with a mom, with conjoined twins and a little red wagon, and you have no problems yourself and you completely understand what your job is today. And it's to help those patients and families get better.

Zafar Chaudry: Yeah, and one thing I've sort of learned being here at Children's. is w e really don't have bad days. Right. When you're sitting in the hospital and you are having a bad day and a sick kid walks up to you with multiple tubes coming out of their body and they actually smile whilst, you know they're in extreme pain.

That's when you realize that I don't have any problems. So my job isn't that difficult, even though I might be sitting there in misery because I feel like it's tough. That's tough and my takeaway every time I see that is that look at the courage of children, a small body, a small person dealing with so much pain, and yet we get miserable about the smallest thing and we are [00:07:00] not really in that level of pain.

So hats off to kids they are very courageous in how they deal with illness. And I wish we as adults had the same level of courage as we deal with our work. Agree.

Drex DeFord: They are the picture of resilience.

Zafar Chaudry: Absolutely.

Drex DeFord: Very optimistic and always figuring out how to bounce back no matter what.

Yeah. I wanna ask you a question. In the world of digital health. all the stuff that you've seen, what's the eureka moment right now? What's the one piece of tech or tech and process that has sort of made you say, well, that changes everything?

Zafar Chaudry: This wouldn't be a discussion if I didn't mention the word AI, and I'm not sure that is my eureka moment though, but I'll mention it

otherwise you won't take me seriously. I would say that I don't think my eureka moment was a single flash. I think it was a gradual realization of the power of interoperability, right? How do you take the record [00:08:00] that is the golden piece of a patient of information and combine it with something robust like a portal and secure APIs?

And then when you process that data and you show how seamless information can flow between different healthcare providers. Coupled with empowered patients, patient access over their data, which then leads to drastically improved care coordination, reduced errors, enhanced patient engagement. To me, that's the synergistic combination and that secure exchange unlocks.

My Eureka moment, right?

Drex DeFord: Everything's connected to everything else. And that may be, I'm with you. I think that's a pretty amazing eureka moment. And kind of speaking of innovation I opened up LinkedIn today. I saw a post from Google talking about their.

Work they're doing with you [00:09:00] around Clinical Standard Pathways, which is all part of that eureka moment. Can you tell me a little bit about that it's been announced. Yeah. So can you tell us a little bit more about it?

Zafar Chaudry: Yeah. So absolutely right. So Drex, when you worked here you would've remembered that Seattle Children's over the 117 years we've been in business.

We lead in the space of writing pediatric care pathways. And over the years we've written hundreds and hundreds of pages of PDFs, of different ways of treating a multitude of conditions. And when you come to Seattle Children's as a new physician, a resident physician, you have access to those pathways.

And congratulations, you can read hundreds and thousands of pages to try and figure out how is the best way to take care of a patient, and it's all evidence-based. Well, that's eye wateringly difficult to do and it's probably unsafe, and how do you validate all of that information? [00:10:00] So in our partnership with Google, we decided, well, why don't we take this problem and throw it at Gemini AI?

And so we took all of the PDFs that we ever have written. In the clinical pathway arena, and many of our pathways are used around the world as a standard 'cause we just give them away.

So we said let's partner with Google and build a tool that could interactively help our clinicians answer the questions on how to take care of a patient based on the symptoms that they presented with.

So now that tool, we put about 40 physicians on this, that tool's been validated. It's more than 99% accurate. And what we found in this journey was first when we threw the information in, it actually showed us areas where we had errors, typographical errors in data that we needed to fix anyway, but we probably wouldn't have found them because who trolls through thousands of pages of, of [00:11:00] information.

And this tool now is interactive. So I can see a patient in the ED and I can say I have a patient who's 12 years old that has these symptoms. Shortness of breath, fever, cough, whatever. The patient has a weight of X, what should I do? And then what Gemini does, it takes the data it's only our evidence it doesn't use a larger model than that.

And it says, well, have you thought about this or it'll ask you questions to get closer to the diagnosis and the treatment program. And through that back and forth interaction between clinician and AI, it gets you to a point where you very quickly can get to a diagnostics, what labs you need to do.

What treatment protocols you need to follow and how you need to take care of that patient, which therefore assists in speed of delivery. It assists in patient safety. It also assists in [00:12:00] training.

Drex DeFord: it doesn't give you one of the prebuilt specific pathways, but it actually helps you create a pathway that's right for you and your patient.

Zafar Chaudry: Yeah so it understands. So it doesn't generate anything itself, but what it does is it understands the data we've put into it. And then it queries your thought mechanism to get you to a point where the treatment plan is correct for your patient. So if I could show you a demo, it's quite interesting to see how it will ask you leading questions to get you to where you need to be.

And it will also reference where it got that material from, in which document in which part of the whole set of pathways, Uhhuh. And the beauty of that is, is in the past you would literally have to go through, in this case, if it's asthma, you'd have to review the entire asthma pathway before you could get to some sort of conclusion.

And that could take you a long time. Now you don't need to do that [00:13:00] because it will narrow it down for you through humble inquiry between you and clinician. So it feels like. You are having an interactive chat with the AI and if you assume the AI is just your phone, a friend, sure. Your phone friend is basically challenging you on your thought mechanisms to get you to a point where you are in good shape for differential diagnosis, your lab testing, any radiology stuff that you need to do and any treatment protocols in this case

patient with asthma. Might need a chest x-ray. Might need nebulization treatment. Might need hospitalization based on acuity of condition, so that's pretty cool.

Drex DeFord: It's like you've got a mentor. Yeah, that's sort of helping talk you through your thinking process for your diagnosis. It's very how did you guys go about doing this?

Was this a, you, the team, [00:14:00] Clara, other folks so it's had an idea or,

Zafar Chaudry: yeah, so it's a multidisciplinary team and we have a full program of AI work that we're doing. We have a review board. The review board is made of multiple clinicians from research to hospital, and they decide what to prioritize.

So yes, the idea came from clinicians. The informatics group had this idea. We then looked at whether we could afford to do it. We then talked to our partner, and Google is our primary partner for all of our analytics. 'cause all of our analytics now are in Google Cloud. And Gemini is our primary partner.

So we went to Google and said, Hey, we have a problem we think we can solve with your technology. They threw some smart engineers into the mix 'cause that's what they're good at. Right. We threw, we had about 40 clinicians work on this, and then they started to build the queries and test the [00:15:00] engine. The engineers ingested the data, made sure the data was clean.

The AI didn't hallucinate on that particular data, but it is all purely based on our evidence, nobody else's so we're not pulling in anything from the internet. It's our instance. It's PHI protected. So it's all in there. And then through multiple iterations, almost six months worth of work design testing.

We've gotten to a point where we're very happy with the output of the tool, and now the tool is ready for primetime hence the announcement. And actually this is being announced this week at Google next as the keynote announcement from Google. I think it's a good example of somebody has a great idea, but IT is a true enabler and it's definitely clinically led.

And at the end of it, the benefit isn't necessarily to us 'cause, which is facilitating the benefit is to the clinical staff it will have [00:16:00] huge benefits in the training of the next generation clinician since we're a residency site. So I think there's a lot of potential for this and you can run it on your

handheld device. You can run it on your laptop, you can run it on your computer on wheels. Yeah. So that's what we're launching. It's ready to go. And it's been a fun project because when people see true benefit of what you can do with the technology, that's really what we're in the business of, right?

Drex DeFord: So it'll work for the, to the benefit of the folks at Seattle Children's will this be one of those things that other pediatric hospitals will be able to tap into the same capability and use it?

Zafar Chaudry: Yeah, absolutely. But the way we look at it is we built the framework. If you want to replace our pathways with your own, ah, you can't, because Google has built the framework with us, it won't take a huge lift.

To extract hours and put yours in. And not every hospital follows [00:17:00] our clinical pathway, so anybody in the world could potentially dump in their pathways. The algorithms that are written by the Google engineers would be valid. I see and then you would need to throw a team of five to 10 clinicians to test that it wasn't hallucinating with your data and it was accurate.

but the framework is built now.

Drex DeFord: I can't wait to see the post game papers. I'm sure that there're between the researchers and the academic folks who are there, there will be a lot of great research reported out on that.

Zafar Chaudry: This is one of the ones we slated to track and publish the before and after, so it will take some time.

But yeah, we'll absolutely scientifically publish it.

Drex DeFord: Fantastic. I wanted to ask you kind of at this, talking about AI didn't mean to get on the AI path, but it is fascinating the battle between human doctors and artificial intelligence. I don't know if it's a battle exactly, but you know, I feel like

there's a lot of [00:18:00] conversation kind of in our business about humans versus AI not just physicians, but nurses and administrative staff. Is there really a competition? I think a lot of folks worry about losing their jobs. what commentary would you make on that?

Zafar Chaudry: I firmly believe there isn't a battle to be won. But rather a synergistic partnership to be forged. If you're looking at team human versus whether you are team AI, I don't think they're in competition. I think they bring complimentary strengths to the table. ' cause human clinicians, they offer what?

Empathy, critical thinking in complex situations, a nuanced understanding of the patient experience. What AI excels in is the data analysis, the pattern recognition, the automation of repetitive tasks, and providing objective insights. So I think the future of healthcare lies in the [00:19:00] effective collaboration between the human and AI.

So you can augment human capability, you can free up clinicians to focus on the uniquely human aspects of care. So job displacement yes, it's a concern, but it needs some proactive solutions focusing on retraining, adapting roles to leverage the strength of both of these things.

Drex DeFord: Yeah. Given new technology coming along, I would say we've gone through this many times.

Folks get upskilled to use the new technology, which makes them usually happier with the work that they're doing because the technology helps them be better at it.

Zafar Chaudry: you've gotta step up or step out, right? Yeah. So yeah, I get the whole, if you look at the Kubler ROS curve, you know the denial.

The anger, the bargaining, right? So yeah, there's a set of denial. Now I'm seeing some anger [00:20:00] 'cause people are protesting AI. At some point people will start to reconcile in their head that it's not something that's gonna go away. So how do you become in parallel and complimentary to the tool and how do your skill sets change?

Because if you think about how a clinician queries a patient in a conversation. It's different than how you would query an AI. This whole concept of prompting, I think what you're gonna see is next generation of physician who hopefully in medical school will start learning the art of prompting so that not only can the clinician speak to the patient in that compassionate human way, but also use the tool to prompt.

And get the answer and assistance that the AI can bring and that's my hope. Now, history tells me that we still don't have EHR training in medical schools. So [00:21:00] it might be a while before we get to prompting, but that's really how the med schools should start adapting themselves.

Drex DeFord: I wanna go down the personal path here.

Last kind of couple of minutes that we've got. You're a sci-fi fan, right? I.

Zafar Chaudry: Yeah, pretty

Drex DeFord: sure I've read that about you or heard that from you. What are you reading right now? What book are you on?

Zafar Chaudry: I'm not actually reading any books on sci-fi,

Drex DeFord: What are you watching?

TVs, movies. What's your favorite?

Zafar Chaudry: Well, I would say that I am a, in the middle, so I'm sort of a hybrid between Star Trek and Star Wars, and if. If most people would tell you about me, they'd probably say, I'm Darth Vader. I'm the evil one because I'm always pushing change. And people tend to say, well, he brings a lot of change.

And so he's sort of akin to the dark side. But I think when you look at the Star Trek universe and you think about. Watching that over the years, when it started in the sixties and beyond.

Isn't it [00:22:00] amazing how, what we saw in the Star Trek universe starting in the sixties and seventies, was technology that is now becoming a reality

Drex DeFord: uhhuh,

Zafar Chaudry: right.

When I think of the cool things, if I was thinking about. What is a great invention that I saw on a TV show? Yes it's gotta be that medical tricorder, right? That device that bones would use to scan you and then it would just tell him everything wrong and then you could take some action.

And what's really interesting is when you look at the internet of things now. All these sensors Yeah. That you can put on your body. And actually I saw a GoFundMe startup for a device that actually brings in six or seven functions into a single device that will look at blood pressure, pulse, a whole bunch of things, and then tell you what may be wrong with you.

I think we're moving in [00:23:00] that particular direction.

Drex DeFord: I completely agree. It is kind of amazing to go back and watch sci-fi shows. It almost makes me think sometimes that the things that sci-fi writers come up with and put into their TV shows or their movies drives. A lot of the scientific investment and exploration like it, it starts as this hair-brained idea on Star Trek and now it's Apple Watch and a bunch of other stuff that just continues to be created and invented.

Zafar Chaudry: Yeah, and I'm sort of a conspiracy theorist because I think that, do they actually use those shows because they already know the technology is coming and they show it to us, get us excited about it. Then miraculously it appears. Right, because this whole concept in the late sixties, early seventies of non-invasive measurement of patients to diagnose a wide range of conditions, monitor vital signs and [00:24:00] provide comprehensive health information at the point of care, looked revolutionary in the seventies.

And guess what? It's the thing now. That's what everybody's doing, between virtual hospitals, hospital at home, remote, patient monitoring, stuff like that. Yeah. That's what people are now really doing. Big health systems are really doing that stuff now. And it took us, what, 30 plus 40 years to get from that show to where we are now.

Even if you remember their screen panels, they would touch things on the screen and guess what? We've got that now. Yeah. So I think, I wonder if they knew we didn't know or they knew. Yes. It's hard to know.

Drex DeFord: It's a big setup.

Zafar Chaudry: I sometimes feel like somebody knows something I don't know.

And then they let us know at some point when they're ready for prime time.

Drex DeFord: Right. Hey I, it's always great to talk to you. I really appreciate you being on Dr. Shari. Come back anytime. You're always welcome.

Zafar Chaudry: Thanks Drex. Thanks for having [00:25:00] me. Always a pleasure to see you.

Thanks for listening to this week's keynote.

If you found value, share it with a peer. It's a great way to discuss the issues and in some cases, even start a mentoring relationship. One way you can support the show is to subscribe and leave us a rating. That would be really appreciated. Thanks for listening. That's all for now.