Stanford’s MCiM Combines Technology, Healthcare, and Business

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Episode 548

Show Summary

In this podcast episode, Linda Abraham interviews Dr. Kevin Schulman, the director of Stanford’s Master of Science and Clinical Informatics Management Program. They discuss the opportunities available at the intersection of medicine, business, and technology, and the problems that you can solve by combining these interests in your career. The program at Stanford combines business courses, technology courses, and ethics to train leaders who can transform healthcare delivery. The program is designed for working professionals and is a one-year, part-time cohort program. Graduates of the program can pursue careers as Chief Medical Information Officers, start their own companies, work in tech or industry, or advance in clinical leadership roles. Finally, the interview concludes with a discussion on the potential risks and benefits of technology in healthcare, and the importance of personalizing healthcare through technology.

Show Notes

What are the opportunities for you, if you’re interested in the intersection of medicine, business, and technology? What problems can you solve if you combine those interests in your career? What education would you require? We’re going to find out in this interview with the director of Stanford’s Master’s program and Clinical Informatics Management.

Welcome to the 540th episode of Admissions Straight Talk. Thanks for joining me. Whether you are applying to a niche, innovative graduate program or more traditional one, the challenge at the heart of admissions is showing that you both fit in at your target schools and are a standout in the applicant pool. Accepted’s free download, Fitting In and Standing Out: The Paradox at the Heart of Admissions will show you how to do both. Master this paradox and you are well on your way to acceptance. 

Dr. Kevin Schulman, director of Stanford’s Master of Science and Clinical Informatics Management Program is also Professor of Medicine at Stanford University School of Medicine and Professor of Operations Information and Technology at Stanford GSB. He is our guest today, and those are just three of his titles. He has several more, along with over 500 publications. His research focuses on organizational innovation and healthcare, healthcare policy and health economics, which leads us directly to Stanford’s Master’s in Clinical Informatics management or the MCIM. 

Dr. Schulman, welcome to Admissions Straight Talk. [2:00]

Oh, thanks so much for having me, Linda.

My pleasure. I’m really delighted to be speaking with you. I saw an ad for the program online and it just felt like such a fascinating program that I looked into it and I thought, gee, it’d be great to have you on. So let’s start with a couple of really basic questions. I am not a techie and I’m not a healthcare professional. I do have an MBA. What is clinical informatics management? [2:05]

That’s a great question. As you think about healthcare compared to other services that you receive on a daily basis, we’re just lagging so far behind in terms of how we provide digital services to our patients, to consumers, how we do follow-up, how we provide education. So we wanted to build a program to help create leaders that will transform the delivery of healthcare in this country and around the world. To do that, we combine business courses and technology courses and ethics in a year long program for working professionals where we meet every other weekend.

So my next question was going to be, can you give us an overview of the MCIM program, and you kind of just did that, but can you go into a little bit more detail about how it is structured and what is actually taught in the program? I mean, again, it just sounds absolutely fascinating to me. [3:06]

So at a high level, when I first started a program like this after the HITECH Act in 2009.

Oh wow, it was back that far? [3:27]

I was at Duke at the time, it wasn’t here, but our CIO said, look, we need more people to help me implement technology. And he saw that actually as a business issue. How do we get cost and quality improvements from using technology? So our curriculum really has evolved from that, but follows, so we need business skills. How do we understand the language of business, how to talk to business leaders at a health system or elsewhere in a language where we make a conversation that they understand. So we do finance, accounting, strategy and management. Two of the courses I really like that are slightly different, one is marketing. So when we go from analog seeing your physician in their office to digital, we actually go from a one-to-one conversation to a one-to-many. And so we’re using marketing tools and strategies all around us to influence behavior. Most of the time it’s to get you to buy products and services, but imagine if we could use those same strategies to help you take your medicines.

To remind you to get certain tests. [4:26]

So that’s marketing. And the final business course is service operations. We do from a machine learning perspective, how do we use this technology to improve productivity at the grassroots level? And then the technology courses are really interesting. So we’re not a programming core, we don’t teach you how to program, we teach you how to work with people who understand these technologies. So of course this is Stanford. So we’re going to start with data science and machine learning. And we have one of the great strengths of Stanford is something called the design school. So IDEO came out of there. Our Biodesign program built a special course for us, Biodesign for Digital Health that looks at needs finding and building solutions that can be scalable and actionable. We also have a data architecture class. How do we understand standards? I teach a course called Health IT and Strategy, which is interesting, which basically again, my background’s health service research, health economics. And so my question is how have other industries used technologies to improve productivity and improve efficiency? And what are those economic models and how can we apply them to healthcare?

And then there’s a stats class we call Quality and Safety in Healthcare because at the end of the day with all this data, we have to understand statistics, but we also have to understand the reports we get as managers and where those data come from.

And then there’s two final pieces. One’s a required practicum project, which is a piece of work that will help you kind of hone in on one of your interests, either to build an interest, to write a business plan, exclude an interest. That has four tracks. You could create a case study, you could do a research project, you could do an experiential project working with leaders at Stanford or beyond. And the final one is writing a business plan. A lot of students do these days. And then the ethics program is a year-long ethics program.

I noticed that. I was very intrigued by the fact that you have an ethical component. So first of all, the program is a one-year program. Let’s just start with that. [6:24]

It’s a one-year program. Yeah, it’s a full Stanford Master’s program. We just hold the classes every other Friday, Saturday.

So it’s also a part-time program. [6:38]

Well, it’s scheduled for working professionals, but it’s-

That’s what I mean. Yes, better way to put it. [6:44]

Yeah, the class hours are the same as if you took a full-time master’s program here.

And it’s a cohort program, right? [6:52]

So everyone starts together and finishes together. There’s 25 people in the program and they become very close friends very quickly. We also rotate, everyone’s on an assigned team and we rotate the teams throughout the year. So you get to meet the other people in your cohort, but you’re all here together in class.

Then obviously you have assignments in between classes. We have guest speakers either on the weekends, you’re here, in between depending on the time of the year.

You mentioned that the program in your head started in 2009, but when did it actually start? [7:20]

Here at Stanford, this is our third year. And Stanford brings a lot to a program like this from the design perspective. Everything at Stanford is AI and ML. Entrepreneurship and innovation is a huge piece of the Stanford ecosystem, but we also have a great ethics program. How do we think about ethical aspects of AI? How do we think about developing technologies? How do we think about deploying them and data privacy? Not only are we dealing with technologies where society’s got lots of questions about the ethics of the technology in the first place, but then we’re applying them to healthcare.

Could you give an example? [8:02]

So how do we think about building models from a dataset? Is there adequate representation of different patient populations in that dataset before we use it? That’s a core basic question a lot of people on campus are asking. And then Dave Magnus, who heads our ethics program, as things come up during the year, they’ll get distracted by whatever the topic du jour is, if it’s vaccines, if it’s data breaches, personal health records, whatever the – he kind of has some core ethical principles to really topical kind of assignments.

I just had an experience today my elderly mother has a video appointment with her doctor and it required my sister or me to go to her apartment to participate in the video appointment because it was not set up so that you could log on from different places. I assume that’s for privacy concerns, but there’s also very definite usability limitations as a result. [8:39]

Absolutely. And fortunately she had you available, fortunately you all spoke English.

That’s true. But I’m going to guess that that would be a reflection of conflicting priorities, usability versus privacy and security or no? [9:10]

Yeah, no, I think it also reflects the question of who are we providing services for and what’s that definition? So the doctor got paid to provide a service to your mother, but your mother needed a service for her and her care team, and that was not in the concept of how we build a CPT code. And so we really had a very limited vision of how we would provide that service under current billing services. One of the things we’re working on right now is just intellectually, what else should you have gotten? So you had your video visit. Did you get a copy of the visit?

No. [10:00]

Did you get any materials like emailed to you about? 

I’m fairly certain that there is an after visit summary. My sister actually was at this thing. She physically went to my mother’s and was on the appointment. My mother’s at an age, and this was of a seriousness where we felt somebody else had to be there. [10:07]

No, absolutely.

But it was not, I don’t, to my knowledge, there’s no recording of it. If there is a recording of it, I don’t know about it. And my mother doesn’t know about it, my sister doesn’t know about it. And there probably is a written after visit summary. Now my mother’s vision is fairly good, but there’s another elderly relative who can’t see. So every after visit summary that she gets is an utter waste of time and an act of frustration for her. [10:25]

And you still have to log into the system to even get that.

Sure. She can’t do that at all. [10:52]

And it’s assuming that after visit summary is written in English and at an inappropriate reading level.

Right. [10:59]

There’s no video. There’s no pictures. So one of the things, actually, this is a long time ago, but we built a personal health record. I was at Duke before Stanford in our portal, and one of the things we linked was pictures of your pills. So your mother’s on X number of pills and if she mixes up the pill bottles, how do you know which one is the blue pill and-

They actually do have pictures of the pills. That I’ve seen. [11:21]

You’re in a good position then.

But those are some of the things just again, personally that I’m dealing with now that have very much to do with information, clinical medicine and yes, management. 

But let’s go back to the program. I could go on like this for a long time and I don’t want to take up too much of your time. In the videos for the MCIM  program, there was a strong emphasis on the entrepreneurial opportunities presented via the program. And you’ve touched on it a little bit. Could you go into that? Could you maybe give me an example? [11:29]

Yeah, so one of the things that we ask, we are here for the students who come here, and Stanford attracts a lot of people who are interested in innovation in entrepreneurship. So they have projects for several of the different classes which can end up being the nucleus for a new business plan. We have this required practicum project that several people last year submitted business plans for. Students either in MCIM or in my other classes on campus are doing work on discharge planning tools, research for rare disease platforms. I was just on a call about a new technology to use voice to help your mom take her meds. So lots of different ideas there, but there are also some ideas that are kind of buried. Can we do better jobs building databases for AI, ML research? That was a big interest of one of the students from last year.

And who is the program intended for? Is it intended for computer science people, for people in business, for healthcare providers? Any of the above? All the above. [12:57]

Well, actually all the above.

Is it more defined by goal? [13:08]

All the students are, I guess the common denominator is they all see that healthcare is an opportunity to make a change. It’s a field, it’s a four and a half trillion dollar healthcare economy, but it’s not an efficient delivery system. And again, not using technology anywhere near the way we should be using it. So all of them are motivated by the opportunity to really make a difference and make a contribution. I try to mix people in the class. We have about 40% with a clinical background, and then the rest are going to either have a business background, a technology background or a finance background. And they’re all going to be on teams, cross functional teams where they have to be able to talk to each other across disciplines. We also do something unique where we’ll take some students right out of college all the way up to people, the oldest person program right now I think is either close to 60 or at 60.

Wow. [14:05]

And so each generation has different ways in which they think about technology, use technology. And so not only do we have to communicate across disciplines, but we have to communicate across generations of technology users. And so that leads to lots of really interesting insights.

Especially in healthcare where you’re typically the older and the elderly use healthcare more than younger people, typically as a group, they are horribly challenged by technology, depending on where in the age span they are. [14:25]

Yeah, that’s a design failure. We should be developing technology that is much easier for them to use. I mean, if my kids make fun of me for how I use technology, so can we make it easier? Can we make it seamless? Can we do some kind of authentication? So I don’t have to remember 6 million passwords. My mother-in-law has got a notebook of all the passwords that she’s forgotten. So she has the passwords, but she doesn’t know what they connect to in terms of the databases. So I think by 2030 we’re going to have 10 million people in this country age 85 and above. If we’re going to have 72 million people in Medicare, we need a healthcare system that provides access to those people. And so the technology’s going to be a lot more useful.

What kind of careers do you anticipate the graduates of the program will go into? [15:21]

So again, I think our idea is these are leadership skills. We’re training you to be leaders to move forward. We’ve gotten some great traction already with things like Chief Medical Information Officers, but other people, a couple have started up companies, smaller, larger tech companies, other people are out in industry. Some of the clinical people are back to their clinical position and moving up in leadership roles there. So it’s a really nice diversity of where they’re going. Also, because it’s a one-year program and it’s pretty intense for working professionals, frankly, I tell people, you’re going to build these skills and then we’ll use it in a career. It doesn’t have to be in this year. It could be in the next year, the following year. And so we’ve seen some of that as well.

I can imagine they can also apply what they’re learning as they’re working since they don’t leave the workforce. [16:12]

Absolutely. Every single day, they come back for the next class weekend. That concept you brought up, we use that. I have another person who’s actually from our first cohort, I was talking to this week and she was opening up her notebooks from class. Literally she just took a new job and she went back and reread all of her stuff. So you can use it, but definitely the business skills and the business concept that you get are things that are going to carry you forward.

What is the application process like? For the MCIM? [16:47]

We really focus, it’s especially after the Supreme Court decision, it’s a holistic review trying to understand where you’re at, what your goals are, what your accomplishments have been and your success have been to date, whether that’s in academia or in the workforce, especially in tech. We have a lot of people in non-traditional career paths to say the least. There’s a guy who has a little company here in Menlo Park who dropped out of college after Harvard. So we have to be flexible. And then we have essays where you really do have to think about letting us know why this is an important program for you, why you’re going to be successful in the program, why you’re going to be a good collaborator in the classroom and with your teammates. And then we’ll do a one-way video interview, and then if people get selected, they’ll have interviewed with two of our admissions committee members.

That’s it. But on our side, the challenge is to really think about a cohort that’s going to work well together in the classroom. It’s going to be a very intense experience. Again, because it’s so focused. Yeah, it’s going to be a very intimate experience because working, you’re sitting next to each other all day for a year, but we also need to have different backgrounds. It can’t be a physician MBA program that there’s no one to learn from all the same set of background. So we need a cohort that can really blend these things together. Because we’re Stanford, we want to make sure we also are building leaders that represent what our country looks like in terms of who’s going to lead us forward and the kind of backgrounds that people have.

You mentioned that the class has 25 members. Is there any interest in growing that number? [18:32]

Yeah, it depends. It’s up to the provost here, and it’s Stanford, so they’ll take their time making the decision, evaluating it, but it’s a permanent program. We’ll always be here. I think we’ve had really good interest in the program and our graduates are doing really well. They’re very happy with the program and the experience, so I’m very optimistic about that going forward.

I noticed in preparing for the call that the application process does not include a test requirement. You give permission or you say that people can share their scores if they have them. Who should share their scores? [19:05]

I think part of this ends up being some people, like our physician applicants, took their MCATs or whatever test years and years ago. So for mid-career professionals, the test didn’t make a lot of sense. So I think if you’re closer to, if you have scores, if you’re on the junior end of the curriculum, that’s helpful. I should say within I think seven years of graduating college, our program participates in a really unique program here at Stanford, the Knight-Hennessy Scholars Program, which has a different application process, but that provides pretty generous financial support. So those people, I think if they don’t have a lot of experience, those scores will be helpful. But for people who’ve been out in the workforce five or 10 years, I think their letters of recommendation and their essays are going to be much more useful.

And I would assume the importance of the GPA also varies depending upon the time that you’ve been out of school. Is that true? [20:09]

Yeah, we need evidence that you can– it’s a rigorous program when your master’s program is, so we want to make sure you can perform well in the classroom. But you can show that in lots of different ways as far as I’m concerned. We’re pretty cognizant of different backgrounds, different trajectories people have had, and we’re looking for evidence of success out there in the workforce.

Now there are three required essays for the MCIM. One is a statement of purpose, which is very common in almost all master’s programs. Another one is a statement I guess, saying how you could enrich the learning community in the MCIM. And the third one is the program time management statement, which given the intensity of the program makes a lot of sense to me. 

How should those three essays provide you with the information that you’re seeking from applicants? I mean, they have different foci, and what advice can you give applicants on those essays? [20:42]

Well, I think that first and foremost is again, the thing that binds everyone together is this, is passion for change. They want to make a difference in the world. A master’s degree, especially for working professionals, is a big investment of time and effort, and we want to make sure that you’ve really considered that and that it really is going to be valuable to you. So I think that’s really helpful to us. And then letting us know how you think that’s going to help you. Either I’m going to go start a company or I’m going to get a promotion or I’m going to move into a different role intellectually. Say you have a tech background and you want to move into project management or leadership or move out of marketing into healthcare, but let us know about that.

In terms of we’re very serious that you’re going to learn, most programs probably say this, but half of what you learn is going to be from your faculty and half is going to be from your colleagues in the classroom. And so we take that very seriously. We want people that could work well with each other as we build the cohort. With 25 people, that is even more important than if it was a bigger program and since we’re in person, it’s even more important than if we were a distance program. So we are not perfect at that, but that’s a big piece of what we do. We’re very happy Cohort 1 and Cohort 2 that finished our programs really kind of love each other. The saddest day of the whole program was graduation when they weren’t going to be together every other weekend for the next year.

And then time management is, again, a chance for them to let us know if they’re working professionals, that they’ve got the schedule down pat, that they’ve anticipated what the requirements are going to be. If they have support from work, that’s also really important. Some of the people have had real challenges. Either your boss is really supportive when you apply in February and something’s happened in the company by June or the managers rotate. It puts a lot of challenge on you. You’ve committed to this program and all of a sudden it’s a real challenge.

Well, thank you for that. We’ve talked a lot about machine learning and AI and all that. What do you think of applicants using ChatGPT to help them with their essays? [23:23]

We’ve written a paper on hallucinations from ChatGPT.

That is one of the better responses I’ve got to this question. [23:36]

My kids text all the time. They’re really good at texting. When they have to do longer form essays they get kind of nervous. But this is your chance to communicate with us and communicate that your level of skill and ability to perform in the classroom, and if you think that’s your level of skill and ability that says something. Hopefully you could do a little better than that.

Is there any kind of career support offered through the program? Through the MCIM? [24:10]

Yeah, actually we’re in the school of medicine, and we have something called the BioSci Careers program, and so they support us in things like resume workshops and networking workshops and job postings, so that those resources are all available. People come to Stanford looking at recruiting all the time, but we also, we’re going to end up with 25 people, 25 different kind of ideas of where they want to go in their career. Though you will have a lot of support, but there’s also a lot of individual networking and responsibility moving forward. Again, you don’t have to change your career just because you come into the program and then obviously you have access to all those resources as an alumni as well.

Do the MCIM students interact with let’s say med students or engineering students or GSB students? [25:00]

Yeah, some of them do. Some of them are just here for the class Friday, Saturday and don’t have any other time. This year we actually have people commuting from the East Coast.

Wow. [25:18]

To come here, so there’s a limited amount that they could take advantage of in terms of Stanford. Some of our international students are here on campus seven days a week doing all kinds of things. The students in the MCIM program have built actually a network of people interested in healthcare here at Stanford in the MCIM program and beyond, and then actually it’s gone national. I think they have a thousand people in their network right now, so there’s lots of opportunities in that direction. Some of our outside speakers, the MCIM students get much better access to them than I also teach at the GSB, so some of the MCIM students get a lot better access than our GSB students even.

Now this episode should air November 7th. Your first deadline is November 10th, so it’s kind of a little tight there, but the final deadline for the cohort entering in June is January 12th. What advice do you have for potential applicants aiming for the January 12th due date? In other words, they will have about two months from the time the show airs to when they submit their application. [25:57]

To me, being on this side of the evaluations, letters or recommendations are so important.

We haven’t touched on them at all. [26:31]

And when you have a lot of people that are really, really extremely talented applying to a program, it’s only letters that can really differentiate you. How do I know about you as an individual in terms of your strengths on a team or leadership capabilities? So if you have the luxury of time, I would think about those letters and who you’re going to ask to write a letter, what part of your background or experience that you want to emphasize through those letters. That’s really helpful.

Great advice. Thank you. Now, let’s say somebody’s listening to this podcast and says, “I’m not ready for this year, but this seems really intriguing and I’d like to plan for it for the following year.” What advice would you have for that applicant, potential applicant planning ahead to apply next year or later? [27:00]

Yeah, like I said, this is a permanent degree. We’re not going anywhere, and so especially for thinking about how am I going to take a year working over the weekend, I’ve talked to people. “I just took a new role. I was really interested in this program. I just took a new role. I can’t go to my boss right now, but I want to do it next year”, and I think that’s perfectly fine. We have information sessions that will start over the summer. I think if you’re ready, you apply during round one in the November deadline. If you’re potentially a candidate for Knight-Hennessy, that’s due in the fall as well. Yeah, I would use this time to just get ready and get the application in.

The advantage of round one, especially for people with clinical backgrounds, my clinical schedule is set a year in advance, so we wanted round one’s there partially so that clinical people could know by December if they’re in the program or not, so they could adjust their schedules if they need to. Lots of advantages to applying then. But between now and then, I think really just trying to think about why do you want to do the program, what other information can you get, I really advise people to reach out to the students in the program.

All the students are telling me that lots of people are reaching out to them, but I could tell you from the head of the program perspective what I think we’re delivering, but they could tell you how it’s having an impact on their careers. It’s everything we’re talking about and more, and they can give you a real flavor for that.

Like I said, this is a big decision. You don’t need a master’s degree to get ahead in your career. Like we started with, again, there’s a really famous dropout here in town that’s done pretty well. A masters degree could help some of the rough edges, but you don’t need it. I was talking earlier today about some of the challenges of single moms taking care of their kids, how would they ever get access to a program like this? Well, it may not be the best. It may not be totally accessible, so I don’t want people to feel bad they can’t take the time off or it’s not the right time of their lives to do something like this. There are short courses, there’s other ways to get some of this material, but I’m really proud of our program and what people are getting out of it.

I think you have a lot of reasons to be proud. Again, it seemed fascinating when I first heard about it, and it seems more fascinating now. As we’re coming to the end of this interview. What would you have liked me to ask you? [29:42]

Oh, that’s a great question. I think you’ve done a really good job of tackling through this. I mean, I think as we look forward, again, we’re trying to tackle this big problem of how do we improve productivity in healthcare? How do we change the healthcare market and why technology? There’s all kinds of other ways you could think about it, and at the end of the day, technology’s, for better or for worse, one of the least regulated spaces in healthcare. And because of that, if you believe in Clay Christensen and disruptive innovation, disruptive innovation only comes in unregulated markets, and so technology’s the only unregulated market in healthcare or the least regulated, and so it’s the one opportunity we have to really make significant change, and I think that’s the reason why we put this program together. That’s why technology is such an emphasis, not only because technology is a great solution to a lot of problems, but technology’s really a way to really dramatically rethink how do we deliver care, make it more affordable, make it more accessible?

Do you think that there’s maybe a risk in depersonalizing healthcare? You go into the doctor and the doctor’s staring at the screen the whole time and not looking at you and that kind of thing? Not exactly the Norman Rockwell image. [31:04]

Yeah. It’s not the Norman Rockwell. I would put it back the other way. I think we’re on the approach of actually being able to personalize your healthcare, because imagine right now while I’m staring at the screen and saying, “Here are the three things that are recommended.” Then we’ll make sure you get scheduled and the amount of time. How do I customize the experience for you? How do I build tools that’ll help you with your personal health goals? Like whatever your exercise plan is, help you take your medicines, help you do your cancer screening. You are paying huge amounts of money for healthcare, and you get no assistance whatsoever in any of those things. It just makes no sense. And at the other end of the spectrum for people with multiple chronic conditions, the healthcare system gets more complex and more difficult to navigate. We need tools to help us do that.

Especially with the elderly. [32:15]

Yeah, so I think it’s actually going to get more personal.

That sounds great to me, and that’s a wonderful note I think to end on also. Increased personalization and improvement in the healthcare system, positive change, and it sounds to me like that’s what the MCIM is all about, right? [32:20]


Okay, great. Dr. Schulman, I think we’re just about out of time. You’ve been very generous. This has been an absolutely fascinating conversation. [32:36]

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