Utilizing digital Health tools to impact care delivery and health equity

August 23rd 2022

The use of real world evidence has entered a new era with direct application within various healthcare areas. Complex scenarios which often lack published studies can be evaluated rapidly and focus on internally generated health data. Drs. Padilla and Lemelle will discuss use of the Green Button Service at Stanford. Our work empowered insights to potentially aid in reducing maternal morbidity and improving health equity. Join us to learn about the service, ongoing work, and potential to serve as an additional tool to impact care quality.

Cesar Padilla

Dr. Cesar Padilla is a double fellowship trained physician in both obstetric anesthesiology and critical care medicine from Brigham and Women’s hospital in Boston. Dr. Padilla has published with leading experts in the field of high-risk obstetrics, and has developed a nationally recognized, multidisciplinary curriculum for critical care in obstetrics sponsored by the Society for Obstetric Anesthesia and Perinatology. Dr. Padilla has co-authored two significant books to guide clinicians on appropriate management of critically ill obstetric patients and several articles regarding health equity in obstetrics and obstetric critical care. He was named Medical Director of Maternal Critical Care at Cleveland Clinic one year of fellowship training, where he introduced the Obstetric Comorbidity Index, a validated screening index predictive of obstetric complications, into Cleveland Clinic’s electronic medical record/EMR. In this position he worked to develop innovative pathways to identify ill obstetric patients while working with obstetricians and educators and currently is a faculty instructor for leading obstetric medical societies. Dr. Padilla is also certified in Echocardiography by the National Board of Echocardiography has participated in several national lectures regarding the management of maternal cardiomyopathies, particularly in an acute perinatal setting. His current research interests include the creation and validation of risk prediction tools to predict maternal morbidity and is actively collaborating closely with Atropos Health, a health/technology firm affiliated with Stanford Medicine in this endeavor.

Chris Lemelle

Dr. Lemelle is a fellowship trained pediatric anesthesiologist currently in private practice. He is the Senior Vice-President of clinical strategy and implementation at Atropos Health. Atropos is a private company which spun out of Stanford based on a decade of research in Nigam Shaw’s lab.
Based on the Green Button service, it is an informatics consult which can answer complex clinical and quality questions to provide statistically validated real world evidence. The platform is active at Stanford Health Care and has worked with multiple departments. Our work with Dr. Padilla
empowered insights to potentially aid in reducing maternal morbidity and improving health equity. Prior to Atropos, Dr. Lemelle led clinical strategy and innovation at CVS Health, HCA, and other tertiary medical centers. As a clinician, he has led Q/A and departments at several hospitals. He trained at UC-San Francisco and ultimately completed his fellowship training at Texas
Children’s Hospital.

Alice R. Georgitso, MPH, joins the SMCI Advisory Committee as our first Patient Partner. Alice has served as a Patient Partner with the Stanford Health Care (SHC) Patient & Family Partner Program for over 4 years and was appointed Chairperson of the Adult Congenital Heart Program Patient & Family Advisory Council in January 2020. She assisted in developing the Stanford Adult Congenital Heart Program’s Peer-to-Peer Program and serves as a Mentor to ACHD patients pre-and-post-organ transplantation. Alice has presented Stanford Health Care’s C-I-CARE framework for structuring best practice communications and developing relationship-based care approaches with patients and colleagues to 500+ Stanford Medicine Directors, Managers and Clinical Staff.

Alice is a Patient Relations Manager at Stanford Health Care. Within her role, she provides a channel for problem resolution to promote the highest quality of care and service excellence. Alice has also worked as an Unrelated Donor Search Coordinator with the Blood & Marrow Transplant at Stanford Health Care to coordinate allogeneic hematopoietic stem cell transplants through collaborative planning and partnership with the National Marrow Donor Program and SHC clinicians. Prior to her work with SHC, she was the Community Service Foundation Director at San Mateo County Medical Association where she partnered with local stakeholders and clinicians to expand county-wide community health programs to diverse populations. She has also delivered invaluable community health services through her work with the American Heart Association.

Alice earned her Bachelor of Arts in Sociology and Biology at Saint Bonaventure University in Olean, NY and her Master of Public Health from SUNY Buffalo in Buffalo, NY. Alice is a member of The Beryl Institute and Adult Congenital Heart Association professional associations, Donor Network West partner advocating for organ, eye, tissue, and blood donation, and remains an active volunteer with SHC. Alice continues to promote patient-and-family-centered care in both hospital and community settings to support precision health and improve the healthcare experience for patients, families, and clinicians.

John Shook learned about lean management while working for Toyota for 11 years in Japan and the U.S., helping it transfer production, engineering, and management systems from Japan to NUMMI and other operations around the world. While at Toyota's headquarters, he became the company's first American kacho (manager) in Japan. In the U.S., Shook joined Toyota’s North American engineering, research and development center in Ann Arbor, Michigan as general manager of administration and planning. His last position with Toyota was as senior American manager with the Toyota Supplier Support Center in Lexington, Kentucky, assisting North American companies adopt the Toyota Production System. Shook co-authored Learning to See, the book that introduced the world to value-stream mapping. He also co-authored Kaizen Express, a bi-lingual manual of the essential concepts and tools of the Toyota Production System. With Managing to Learn, Shook revealed the deeper workings of the A3 management process that is at the heart of Toyota’s management and leadership.
Shook is an industrial anthropologist with a master’s degree from the University of Hawaii, a bachelor’s degree from the University of Tennessee, and is a graduate of the Japan-America Institute of Management Science. At the University of Michigan, he was director of the Japan Technological Management Program and faculty member of the Department of Industrial and Operations Engineering.
Shook is the author of numerous articles, including "How to Change a Culture: Lessons from NUMMI"; Sloan Management Review, January 2010, which won Sloan’s Richard Beckhard Memorial Prize for outstanding article in the field of organizational development.

The Stanford Medicine Center for Improvement benefits from the diversity of its members and the richness of the experiences that they bring. Although the program continues to evolve from when it first launched in October 2019, we continue to reach out to improvers across Stanford Medicine in the School of Medicine, Stanford Health Care, Stanford Children’s Health, Stanford ValleyCare, UHA and PCHA. We welcome everyone from every discipline and recognize that we are stronger together as we value the contributions of every member of our teams.

Dr. Paul Maggio is the Chief Quality Officer of Stanford Health Care. Prior to being appointed the SHC CQO, he was Vice Chair of Surgery for Clinical Affairs, Associate Chief Medical Officer of Operational Effectiveness, and Associate Director of the Adult Intensive Care Unit. He trained in General Surgery at Brown University and obtained advanced training in Adult Surgical Critical Care and Trauma at the University of Michigan. He holds a Masters of Business Administration from the University of Michigan and is triple board certified in General Surgery, Critical Care, and Medical Informatics. In addition to being a clinician and surgeon, Dr. Maggio participates in the National Committee on Healthcare Engineering for the American College of Surgeons, and his research interests are focused on the delivery of high-value care.

Dr. Maggio received the SHC Board of Hospital Director’s Denise O’Leary Award for Clinical Excellence in 2013

Micah Duchesne joined Stanford Medicine in 2020 as a Principal Consultant project managing the deployment and operations of the Hospital Incident Command System (HICS) for COVID-19. He is now the Administrative Director of Performance Improvement at Stanford Health Care where he leads annual operations planning, improvement consulting, and capability development. Micah is also a Fellow at the Stanford Medicine Center for Improvement.

Before joining Stanford, Micah was an independent consultant for his company Silicon Valley Strategy Group, which partnered with Novartis and the Perelman School of Medicine at the University of Pennsylvania to commercialize cellular therapies. He led a team of clinicians from Europe, Japan, and Australia in designing a global logistics model and quality management system for Kymriah, the world's first approved CAR-T therapy, and helped create an international advisory board aimed at improving global capacity.

Prior to independent consulting, Micah was the Director of Performance Improvement at Kaiser's Santa Clara Medical Center, and he previously held improvement roles of increasing complexity within other health systems. Micah has both a Bachelor of Science in Accounting and Master of Health Services Administration from Mississippi College. He also holds certifications as a Lean Six Sigma Master Black Belt and Project Management Professional.

As a professional, Micah enjoys organizing complex stakeholder ecosystems, clarifying ambiguous goals, aligning visions, and driving high-stakes change. As a human, Micah just enjoys breaking a sweat. While he's not at work, he's at his very own gym in San Jose, CrossFit Moxie. You can find him there coaching olympic weightlifting or working out with his wife. He has a daughter in elementary school and two gym dogs.