February Lecture

Leveraging quality improvement, design thinking, and simulation when studying and implementing health AI technologies

If you consider the world of drug discovery many decades ago, there was an enormous gap between scientists in the lab making breakthrough discoveries and the physicians at the frontlines treating patients at the bedside. It was not until the concept of translational research came about that we were finally able to realize the potential of those lifesaving discoveries by moving them from bench to bedside. The exact same problem is happening in healthcare artificial intelligence (AI) today, inspiring the development of the Stanford Healthcare AI Applied Research Team (HEA3RT) in the Department of Medicine. HEA3RT’s mission is to bring cutting-edge AI technologies from code to bedside in support of the Quadruple Aim.

Recognizing that current approaches and traditional research methods often do not support successful AI implementation in healthcare, the HEA3RT team has designed a repeatable mixed-methods approach leveraging quality improvement and design thinking that facilitates uptake of AI technologies into human-driven healthcare processes. An important step in translating technologies from code to bedside is the ability to simulate and iterate quickly, leading to the development of the HEA3RT Simulation Lab. The simulation lab serves as a unique venue where faculty, students, and engineers can be more easily involved in the process of developing AI technologies and the workflows surrounding those technologies. This talk will discuss design thinking, and simulation when studying and implementing health AI technologies, examples of real-world projects partnering with technology companies, and pathways toward future growth of AI in healthcare.

Steven Lin

Dr. Lin is the Executive Director of the Stanford Healthcare AI Applied Research Team (HEA3RT). He is an expert clinician, researcher, educator, and health system leader in the specialty of family medicine. Dr. Lin earned his MD from Stanford University School of Medicine and completed his medical training at Stanford’s family medicine residency program at O’Connor Hospital. He has received numerous national awards and is recognized among the top family physicians in the United States.


Dr. Lin is the Service Chief for Family Medicine at Stanford Health Care. Dr. Lin has a particular interest in preventive cardiology, diabetes, viral hepatitis, and mental health. He is proficient in a wide range of primary care procedures – including over 40 different skin, musculoskeletal, and women’s health procedures that are performed in the office.


Dr. Lin is the author of over 250 scholarly works and conference presentations. He is the Vice Chief for Technology Innovation in the Division of Primary Care and Population Health at Stanford. Dr. Lin’s current focus is on artificial intelligence in healthcare. He is a consultant and mentor to technology companies in the United States, Canada, Europe, and Asia.

Margaret Smith

Margaret Smith is the Director of Operations of the Stanford Healthcare AI Applied Research Team (HEA3RT) where she works with industry partners, and clinical and operational leaders at Stanford on the application, development, and implementation of artificial intelligence technologies. Her expertise lies in healthcare quality improvement, complex problem solving, facilitating cross discipline collaboration, and design thinking. Her passion is building applying collaborative mix-method approaches developing, integrating, and studying technology solutions in healthcare that work for providers and patients rather than impede care delivery.

Previously, she held senior positions in quality improvement for many years in academic and non-academic medicine garnering extensive experience in a broad set of organizational and incentive structures.

Margaret holds a bachelor’s degree finance and risk management, a master’s in business administration with a specialization in healthcare management from the Baylor Hankamer School of Business, Robbins Institute for Health Policy and Leadership, and a Leean Six-Sigma master black belt certification.

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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 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.