Stories: Voices from the frontline

Chris Dale, M.D., MPH 

Chris Dale, M.D., MPH 

When asked what we can do for patients with the Swedish Transfer and Operations Center (STOC), Chief Medical Officer Chris Dale, M.D., MPH, sums it up like this: “The purpose of STOC is to create health.”  

This proposed 16,000-square-foot facility in Georgetown will serve as the nerve center for all five of our hospitals, employing a mission control–style data hub to give our team a real-time look at the status of all of our beds at once.  

When patients and their family arrive at one of our emergency departments, they’re already anxious and fearful, unsure of what will happen next. The last thing they want is to wait to feel better. STOC will ensure they receive the care they need, when they need it.  

Dr. Dale is bullish about STOC’s potential for providing health care of the future and offered us an inside look at how it will change the game for our patients.  

How will STOC improve patient care?  

As a patient, what you want is simple, perfect care, right at your fingertips. No one likes going to the hospital. It’s painful, right? There’s waiting and queues, and it’s confusing.  

On the caregiver’s side, health care is extremely difficult to deliver perfectly. We don’t make lattes. Humans can break in an infinite number of ways. There is no book, no single source you can refer to when caring for a patient.  

The goal with STOC, on the caregiver’s side, is to reduce the variables in care—through predictive modeling and tracking information in real time—and make providing care more like making a latte.  

From the patient’s standpoint, the goal is to provide the right care, at the right time, in the right place. It’s about decreasing friction, increasing joy and improving the value of health care that we deliver.  

In what way do we want to increase joy?  

Avoidance is a lot of people’s health care strategy. So when trying to address that, it’s helpful to think about that in terms of joy or restoration. That’s the essence of what medicine is.  

What we try to do is really help people live their most joy-filled, complete lives and understand their journey through their life. We want to partner with them to provide the services they need to get back to joy, get back to living a full life. 

Take acute hospitalizations. They’re very, very rare. Acute care hospitalizations tend to fall into three buckets: people who have chronic, severe illness; a very bad episodic thing; or they’re toward the end of life. Our goal should be to understand what their goals are and then figure out how to have their time in the hospital be as peaceful, restorative, efficient and effective as possible so that they can be back with their loved ones and back to living life. 

Artificial intelligence will play a large role in STOC. Can you explain that? 

Calculating risk and maintaining vigilance are really tough problems for the human brain. AI is a way to minimize risk by recognizing things that humans—in our very limited cognitive capacity—can’t recognize on our own. 

Imagine all of your data for all of your patients as one big real-time data set. Now imagine if you could build a series of rules that were operating in the background and could notice trends in a patient’s condition well in advance of their taking a turn for the worse. And imagine if that system could send an alert to a caregiver to take a closer look for things they may be missing.  

Sepsis is a good example. If you can notice it an hour earlier and start interventions, you will save lives. I think of AI as traffic lights or lights on a dashboard that flash if there’s a probability of something happening. The idea is that those rules operating in the background would be based on the decades and decades of data that we’ve collected on sepsis and recognize problems before a physician could. 

How will STOC help reduce the amount of time they spend in the hospital? 

In any multi-step process, delays get compounded. The STOC is a delay zapper. It finds your inefficiencies, zaps them and then allows you to get out of hospital. 

STOC is not very complicated from a theoretical perspective. All it does is takes the hundreds or thousands of people that are necessary to care for any one person and better orients them around how things are going and what they need to do in order to move this person along in their journey. 

STOC will also improve telehealth. How? 

I’m a critical care doc. What patients pay me for is right between my ears—it’s knowledge and training and expertise in delivering critical care. But I can do lots of those things from the office above my garage in Snoqualmie, and the patient could be in Seattle or Shoreline or Hawaii. 

It costs very little to move the electrical impulses that make up my knowledge. It costs a lot more to move people. So the more we can move that knowledge and the less we can move people, the quicker, better and more cost-effective it is for everyone involved. 

So in addition to providing a space for conducting telehealth appointments—the goal here is to have a group of experienced, trained ICU nurses and providers at STOC, practicing side by side with the operations people—we’ll also create a tele-consult network. 

I’m a decent pulmonary critical care doc, but I’m not the best in the world. Imagine if I’m with a patient and I have a question and I call someone else from our group who I know is an expert in what I’m trying to address. She joins the appointment via camera, talks to me, talks to the patient, talks to the patient’s family. 

We can do that without STOC—eventually. But what we’re trying to do is accelerate that process and get to the future model of care more quickly. That requires a group of folks who are oriented around answering the question, How do we solve this problem together? That’s what STOC will help us do. 

STOC will be a vital component of our ongoing response to COVID-19. Join us September 9 for a special conversation with Dr. Dale and Chief Operating Officer Kevin Brooks about how technology is helping us care for our community during this fifth wave. Visit www.swedishfoundation.org/ve/covid to register.

For more information about STOC and the future of health care, please contact us at: 206-386-2738 or [email protected]