To meet the needs of tomorrow’s doctors and patients, medical education must evolve. At the proposed Kansas College of Osteopathic Medicine, we’re rising to meet this challenge with a curriculum that integrates advanced technology and medical intelligence. To ensure this, we’ve partnered with Medical Intelligence 10 and will be the first school of osteopathic medicine in the country to incorporate its unique modules—ranging from entrepreneurship to monitoring technology and population health.

 

Members of our leadership team recently gathered to discuss the partnership and how the proposed college is poised to change medical education for the better. The panel included Joel Dickerman, DO, dean and chief academic officer; Michael Finley, DO, senior associate dean at KHSC who specializes in rheumatology and internal medicine; and David Ninan, DO, KHSC assistant dean who is leading the school’s Center for Innovation in Healthcare and Education, which will become an industry leader thanks to MI10’s intelligence curriculum.

 

The following transcription is from the panel discussion. You can also watch the discussion here.

 

Let’s start off by talking about the changing landscape of health care. Why is technology like what MI10 offers so critical?

David Ninan, DO: This question cuts right to the heart of a major change going on everywhere, especially in the world of health care. And that’s, as a society, we’re moving from an age of information to an age of intelligence. That plays itself out several ways in medicine and health care. One is the massive amounts of medical knowledge and information. To get a handle on the scale of it, in the 1980s the doubling time for medical knowledge was about two years. So it was not uncommon for a medical school class to hear a lecture go something like, “During the course of your four years of training, you’re going to learn a lot of cutting-edge science and technology. At the end, about half of what you’ve learned will be wrong.” But the problem is, how do you know which half?

Now, if we fast forward to the 2020s, it’s been estimated that the doubling time for medical knowledge is about every 73 days. So you can see that the cognitive or knowledge load that’s placed on the shoulders of physicians in the present state, that’s going to accelerate as this continues to escalate.

In addition to that, when we look at the amount of information that’s available, you think about our smart phones, our personal wearables, in the medical specific space, implantable devices like pacemakers. All of this is continually generating useful information that can make treatment decisions different depending on what that information says. And if you think about how this might impact the diagnosis side, for example, when your car makes a funny sound and you take it to the mechanic, and of course, it doesn’t make that sound at the mechanic. Or you’ve got a pain somewhere. And by the time you get into the doctor, you see them, and of course, the pain is not there, and they can’t figure out what’s going on. How do you know if that pain that you were having didn’t resolve? Was it a symptom of something worse? Is it the beginning of a bunch of problems?

Sometimes it’s very, very difficult to know when you’re looking at one point in time and all the information available at that point in time. But if you can add all of the bits of data and bits of information and piece them all together, then there’s a much greater ability to diagnose something accurately with a greater inclusiveness of information.

To flip that around to the treatment side, when you’re looking at the treatments in the ICU, for example, treatment is done in real time. So your vital signs change, a medication is changed, intervention is performed. Where in the current outpatient setting, about every 30 days you go see a health care provider, there’s an adjustment made to your treatment regime. If we could get that information going, flowing continually to the health care system, then there’ll be the ability to make day-to-day changes and adjustments, so the level of the quality of the care will improve.

Finally, and probably most importantly, physicians have always lived in that interface between the science and technology, and the humanity of health care. No physician ever decided they wanted to be a doctor to sit behind a computer screen. In no place is it more important than when we have this escalating amount of medical knowledge, escalating amount of data, where a physician is able to accurately and effectively communicate that and work with and partner with people in their own health.

So really, what we’re looking for are physicians who are thinkers, takers, doers, and dreamers, who truly have a calling to make a difference for their fellow humans.

 

How has COVID-19 had an impact on some of those considerations that you just mentioned?

Joel Dickerman, DO: I think the pandemic is a perfect example of where technology can help and where we still need to rely on technology to improve our services. Technology obviously helped us to develop vaccines and some of the treatments that we now have available in an extremely short period of time. What used to take months and years, we were able to accomplish literally in weeks and months, which has been remarkable.

We were able to develop telehealth so that we could reach out to people and meet people that had access issues, that couldn’t come to a hospital or to a medical provider.

On the flip side, I think we also found out that we have to learn better to manage the data that was presented and the information that evolved out of this illness. Unfortunately, there was a lot of misinformation, and there is just difficulty getting out information. And again, we’ve seen continued health disparities on certain populations of patients that could not receive treatments or were more highly affected by that disease.

So I think the pandemic is a great example of what technology can do and more importantly, how we can use technology to better deliver care to individual patients and to whole communities.

 

As we talk about this technology that MI10 offers, can you talk about the modules and how this works?

Michael Finley, DO: The modules really should be thought of in a better way of themes that will be woven throughout the curriculum. And the learner, the future student, the future colleague who’s going to practice for the next 30 plus years needs to be engaged because they themselves are different. They’ve been learning through the pandemic and caring, as Dr. Dickerman mentioned, has changed a bit now because we are utilizing tools like telemedicine. And yet, as good as telemedicine is, you still have to see people in their own space, whether that’s a home visit or whether that’s an office visit. Rendering surgery, where you can do some things robotically and maybe even at a distance, you probably have to do a lot of things in person.

So taking those students who are used to utilizing all forms of technology, and then bringing these themes of what a future health care landscape is going to look like, and equipping them to manage effectively and work effectively in that environment as a member of a team. Partnering with their patients with the latest information and understanding how to unpack that information and really get the important pieces of data to inform customization of precision medicine, if you will, of what kind of treatment plan and diagnostic plan are you going to suggest for your patient that will be best for their health care outcomes. All of this is something that the three of us never got in our own medical school curriculum.

So one of the things that we’re attempting to do is to make space not just by adding, but by really scrutinizing what needs to stay in the curriculum, what can be done in a different way, what might come out, so that we can make certain that when a graduate leaves, a future colleague, and they go off to their specialty training, they are ready to do the work, to modernize the work, change the work.

And for all of us who in a very short order will be receiving the care from these graduates, we know that they’re going to be the most skilled, the most modern, and really, in a great opportunity, the most intelligent because they’re utilizing the latest information and the latest tools combined with their wonderful humanity. It really is a synergy that we believe is going to really make a difference and set our graduates apart from their peers.

 

This isn’t necessarily a medical technology or intelligence that’s a piece of plug and play software. This is part of your holistic approach to tomorrow’s doctors, right?

Dr. Finley: Absolutely, I think that one of the things about an osteopathic school is that we have always valued that the patient is at the center. And that patient comes with their illness, they come with their concerns, they come with their culture, they come with their spirit, they come with their humanity. And once their illness or their disease process is addressed, then we really want to be mindful and intentional about keeping them well.

Many, many patients are able to access the same search engines that we all use, and they come in with a pretty good idea. Because they’re living in their own skin all week long, they have a really good idea of what’s going on. They might even have made the right diagnosis because they use a lot of the same, accessible tools that we do. And yet, once we resolve those issues, or if it’s a chronic condition, manage those issues, we then want to get them as well as they can be. Wellness is a tremendous part of that.

The other side of the coin is let’s keep the health care team, the nurses, the doctors well, as well. And one of the things that we all are concerned about with the pandemic is not only the impact on patients and their families and their communities, but the impact on the health care team and making sure that they stay well so they can render the care that we all need.

 

When we talk about the acceleration of how the application of medical education has changed rapidly over the course of the last several years, how do you take this information and then continue to make it progressive and forward for the students of today and the students of the next 30 years?

Dr. Dickerman: I think a critical aspect of our education is teaching our students how to learn, how to continually learn, how to think, how to solve problems. It isn’t just the information. It’s how you deliver it, how you apply it, how you apply it to an individual’s personal needs and a community’s needs, which can sometimes vary greatly. It’s very much a process for teaching, not just a skill set.

Dr. Ninan: To give an example, building on what Dr. Dickerman said, is these themes, as Dr. Finley alluded to, are interwoven throughout. For example, a focus area is diversity, equity, and inclusion. That can interface with a physician’s practice in many levels. It can apply in the one on one at the bedside, it can apply when the physician is in a leadership type of role. But it can also be applied in a way that often people don’t think of. And as we’re moving toward machine learning, artificial intelligence, and setting up these protocols and algorithms, if these protocols and algorithms et cetera, are not done in a very precise way, you can inadvertently have things that can be very discriminatory or very problematic.

 

So it’s very, very important that these positions are going to be taken care of. You, me, and us are very cognizant, very educated in this, very aware of that. So they cannot only take advantage of the things technology offers, but they can help avoid some of the potential problem areas that will arise.

 

To close out the discussion, as you think about welcoming the first cohort at the proposed KansasCOM, what does it mean to you to be the first medical school in the country to be formally utilizing this intelligence?

Dr. Dickerman: I think we have a wonderful group of individuals applying for medical school now. We’ve seen a huge surge in the number of people wanting to enter the health care arena — particularly medical schools — and I think this is a result of the pandemic and an underlying desire to want to help and advance how health care is being delivered. It’s a great opportunity to match that desire up with what we see is going to develop in medicine and in the needs of our patients in the future. Again, we have an opportunity to literally build a building from the ground up, but more importantly, to build a curriculum and a faculty that will meet the students where they are and improve care, I hope over the next 30 to 40 years.