Tech Tonics: Laurie Zephyrin, MD: Public Health as Destiny

03/23/20 • 34 min

Dr. Laurie Zephyrin was disappointed to learn that a less-than-rock-star voice was going to stand in the way of her career as a singer, but fortunately she locked onto her healthcare destiny in her teens. A formative moment in high school set Laurie Zephyrin in the direction of public health and she has never looked back. This path has taken her through the White House, the Veterans’ Administration, into tiny villages in Africa and back to New York City. Through it all, Laurie is always seeking to drive towards a high-performing healthcare system, and especially one that effectively meet the needs of underserved populations.

Laurie went to medical school and became an OB/Gyn, heavily influenced by Dr. Jack Geiger at CCNY, who was a leader in bringing the concept of community-based care and the importance of human rights and social determinants of health to the fore.

She spent time after as a White House fellow, assigned to the Veterans Administration to assist with the medical impact of Hurricane Katrina, among other things. After a stint in community practice, Laurie returned to the VA as the first National Director of the Reproductive Health Program, where she had to undertake a major system redesign to transition a program designed to serve male soldiers to one that served all genders well. In 2016-2017, she became Acting Assistant Deputy Under Secretary for Health for Community Care, and later Acting Deputy Under Secretary for Health for Community Care, managing a $13B budget in a system that was getting a lot of publicity, not always the good kind.

Along the way Laurie became a Robert Wood Johnson Clinical Scholar and then Aspen Institute Health Innovation Fellow (where she met Lisa). She also earned an M.B.A. and M.P.H. from Johns Hopkins University to augment her M.D. degree from the New York University School of Medicine.

Laurie recently left government to broaden her impact on public health through her leadership role at the Commonwealth Fund, one of the first private foundations started by a woman in 1918. It’s a perfect match in many ways, given The Commonwealth Fund’s mission to promote a high-performing health care system and Laurie’s commitment to improving health for all, but especially women.

Tech Tonics is sponsored by Manatt Health, a multi-disciplinary professional services firm that includes a full service law firm and a broad-based strategic business and policy consulting practice to help clients grow and prosper. Manatt Health supports the full range of stakeholders in transforming America’s healthcare system.

Previous Episode

Tech Tonics: Dr. Lynda Chin – Bringing AI to Medicine Through Infrastructure

Taking on challenges is nothing new for Dr. Lynda Chin. It started with learning English well enough in a couple of years to graduate valedictorian of her high school, evolved to a distinguished career as a physician-scientist and then full professor at Harvard & the Dana Farber Cancer Institute, and ultimately led to her current role as founder and CEO of Apricity, seeking to bring digital technology to improve the care of oncology patients.

Lynda Chin’s family emigrated to the United States from China when she was in high school. Through determination, and with the help of television (she cites “Starsky and Hutch” as her primary vocabulary inspiration), she taught herself English, graduated at the top of her class, and went to college at Brown University, where she created her own major – neuroscience – and conducted research involving echolocation in bats.

Over time, she became interested in molecular biology, attended medical school at Albert Einstein College of Medicine, and continued her training in internal medicine and dermatology, while developing a research program on mouse models of cancer, which she was then recruited to Harvard to pursue.

An unanticipated setback at the lab – a mouse hepatitis virus infection in the mouse facility wiped out her engineered mouse colony, putting much of her research program on hold– led her to focus on the emerging technology of transcriptome profiling at scale. She adapted it to engineered mouse tumors for cross-species comparison, and more broadly, to an expertise in translational oncology, which she pursued at both the Broad Institute and the Dana Farber Cancer Institute as part of The Cancer Genome Atlas (TCGA) project. She was particularly proud of the work in building the genomic data analytic pipeline (Firehose) to enable not only access to but use of TCGA data by the broader community. She rapidly rose through the ranks to the level of full professor, and was elected to the National Academy of Medicine for her research contribution.

Lynda ultimately decided she was ready for the next challenge: she joined MD Anderson Cancer Center with the idea of creating a forward-looking translation-centered department to develop technology and analytic infrastructure to enable Genomic Medicine. She was also interested in the promise of AI, and helped set up a collaboration with IBM Watson to explore its application in cancer. This project surfaced important hurdles for effective and responsible application of AI in the healthcare context.

Lynda is now applying these lessons as CEO of Apricity, a digital medicine company seeking to leverage data and AI to close the gap between promising clinical trial outcomes and the often more disappointing results in real-world care. She is also championing the importance of pragmatic implementation of AI and other technologies in medicine, a focus of an upcoming conference she is leading in Boston (David is also on the organizing committee).

Show notes:

David’s recent Wall Street Journal review of Facebook: The Inside Story, by Steven Levy here.

“AI and Big Data In Cancer: From Innovation To Impact” Conference, March 29-31 in Boston, more here.

Next Episode

Tech Tonics: Torrie Fields, The Business of Making Better Memories

A childhood fraught with illness, loss and uncertainty drove Torrie Fields to an adulthood focused on making these experiences better for others. Torrie sincerely believes that we are all here for a reason and that her reason to is help people have more dignified, less painful experiences at the end of their lives.

Having learned early in life that you could take nothing for granted and that you really need to show up when things are going in the right direction. Torrie has parlayed these guiding principles into an accelerated and notable career, culminating in the founding of Votive Health, which she views as a company in the business of making better memories – by that she means, “There is an intimate tie between how you die and how people remember you.” Votive Health is also a company focused on using data and people to help manage the care of patients with serious illnesses. The company, which is now launching, also works firsthand at the intersection of illness, insurance and employment, which is clearly a critical confluence at this currently challenging time of COVID-19. Notably, David and I recorded this show well before we knew what was coming on the plague front. This show seems particularly relevant now.

Torrie’s early career you focused on emergency preparedness and epidemiology with a special focus on systems design. This skill set served her well through her time at McKinsey and then later, when she somewhat randomly applied for an actuarial program at Cambia Health Solutions, the parent of Regence Blue Cross Blue Shield and several other companies. The wonderfully kind and very community-minded CEO of Cambia, Mark Ganz, encouraged employees to seek a special project that was meaningful to them – ultimately this led Torrie to found and ultimately lead Cambia’s palliative care program. She later joined Blue Shield California to start a similar program. She later joined Blue Shield California to start a similar program.

Torrie discusses the challenges at the intersection of palliative care, end of life vs. the traditional medical and insurance systems, where there are no standard definitions of palliative care, few appropriate payment models, bad program packaging and low prioritization. Given the current COVID-19 environment, perhaps we will see some changes in that.

We loved having Torrie on the show, as despite what can be a dark topic, she is a perennial ray of sunshine.

We are grateful to Manatt Health for sponsoring today’s episode of Tech Tonics—Manatt Health is a multi-disciplinary professional services firm that integrates a full-service law firm with a broad-based strategic business and policy consulting practice to help our clients grow and prosper. Manatt Health supports the full range of stakeholders in transforming America’s healthcare system.

Show Notes:

A useful article about COVID-19-related advanced care planning from the Kaiser Family Foundation can be found HERE
A prior post by Lisa on end of life is HERE.