Dr. Roni Zeiger: Technology + Care

reprinted from Issue 22, Spring 2016 of Frontiers of Medicine (PDF)

"I think each of us has a responsibility to help our families, our local community, or the global community in a way that best matches our skills and passion." – Roni Zeiger, MD, MS

Throughout his career, Roni Zeiger, MD, MS, has sought ways to combine his love of science with his passion for helping others. As an undergraduate, he found lab research lonely, but enjoyed working as a medical interpreter. “From day one, patients were telling me things," he said. “I saw that medicine was a way to do science and people at the same time."

As a UCSF Primary Care Internal Medicine resident, one of his mentors was Stephen McPhee, MD. “He has a special blend of humility and wisdom," said Zeiger. “The best leaders make their team think it all comes from the team." Residency provided superb leadership training. “One of the most difficult but important aspects is delegating thoughtfully – knowing when you can completely depend on someone, when you need to check up on them, and what to do when things aren’t going well," he said. “It’s a delicate balance of maximizing individual learning, the team’s success and patient care."

Zeiger started building software in medical school, and developed a digital compendium of symptoms and corresponding diseases. In partnership with McGraw-Hill, Zeiger built this into Diagnosaurus, a mobile app that reminds clinicians of possible diagnoses.

“In a stellar group of UC Primary Care Internal Medicine residents, Roni was clearly one of the best of the best!" said McPhee. “A terrific doctor, he has spent much of his career focused on the relatively new field of medical informatics. Diagnosaurus is an extremely useful tool. I use it when presenting a case where the diagnosis is puzzling. Invariably, it helps."

Patient-Centered Design

After residency, Zeiger worked as a primary care physician but missed his “nerdy side projects," He enrolled in the biomedical informatics master’s program at Stanford, studying how patients use the Internet. He became chief health strategist at Google, overseeing projects that included Google Flu Trends and Google Body. “Google is where I learned user-centered design, which has beautiful parallels with patient-centered medicine," said Zeiger, who continues practicing medicine part-time. “I’ll often ask patients, ‘What do you think is going on?’ which elicits a thoughtful response that sets the tone for collaborative work. With software products, the user is the expert at understanding the problem, and the developer can build possible solutions."

For example, in response to user feedback, Zeiger’s team enhanced the search results page so that people Googling “suicide" now see a hotline number at the top. “In a week, that probably touches more people than I’ll ever interact with in my whole career," he said.

He also oversaw Google Health, which sought to make users’ health information accessible online. However, it fizzled – perhaps a venture ahead of its time. “People couldn’t easily refill a prescription or get a high-quality second opinion," said Zeiger. “Big ideas that don’t solve tangible problems might not succeed."

Smart Patients

In 2011, Zeiger developed a brain hemorrhage, but made a full recovery. “While lying in the neuro-ICU, I realized I just got a free pass, and wondered what I should do with it," he recalled. He and Gilles Frydman – a pioneer of medical online communities – then co-founded an online peer support network for patients and families called Smart Patients (smartpatients.com), which allows patients and caregivers to support and learn from each other.

Smart Patients also aims to improve health care by enabling patients to participate in quality improvement work with partnering medical centers. “Instead of thinking about patients as passive recipients of our care, let’s think of them as collaborators in generating hypotheses and redesigning how care is delivered," said Zeiger.

Zeiger continues to work a few urgent care shifts per month at Santa Clara Valley Medical Center. He and his wife, Leslie, have two young children, Lev and Ana.

His advice to residents: “Find out what you really care about, and figure out how to do it. There won’t necessarily be a paved path. I think each of us has a responsibility to help our families, our local community, or the global community in a way that best matches our skills and passion."

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