In early May, Lalita and Kelly attended the Starfield Summit, a collaboration between the American Academy of Family Physicians and Rock Health, in Kansas City, MO! In this episode, they reflect on the conversation at the summit and their key takeaways on the principles that can guide AI development to support primary care with ground truths, including the 4 Cs of Primary Care (Comprehensiveness, First Contact, Coordination, and Continuity) which were inspired by research from the summit's namesake, Dr. Barbara Starfield. AI is a value-system encoded into our workflows, so how do we encode the vision of health care we wish to see? Join Lalita and Kelly to hear their takes on the intimate conversation with representatives from digital health, industry, legal, regulatory, insurance, and of course LOTS of primary care physicians.

1. Starfield Summit: www.starfieldsummit.com

2. Artificial Intelligence and Machine Learning for Primary Care Curriculum (AiM-PC). Society for Teachers of Family Medicine (STFM) https://stfm.org/teachingresources/curriculum/aim-pc/aiml_curriculum/

00:00 Introduction and Hosts

00:22 Casual Chat and Catching Up

01:04 Starfield Summit Experience

01:46 Round Table Discussions and Key Takeaways

04:02 Primary Care and AI Integration

04:38 Barbara Starfield's Legacy

06:38 Rock Health and AAFP Collaboration

07:36 AI in Primary Care: Survey Insights

10:45 Innovating for the Right Reasons

14:13 Challenges and Considerations in AI Implementation

18:25 Regulatory Concerns and Future Directions

20:07 Personal Reflections and Fulfillment

20:44 The Great Horse Manure Crisis of 1894

21:33 Healthcare Analogies and Challenges

22:05 Leveraging Family Medicine for Research

22:53 Adopting AI in Personal Practice

23:29 Clinical Decision Making with AI

24:55 AI in Knowledge Management

26:51 Ethical Considerations in AI

29:57 Future of AI in Medical Education

34:15 Concluding Thoughts and Future Topics

In April, Kelly gave a talk called "Reducing Administrative Burden for Family Physicians" to the Texas Academy of Family Physicians at their Lectureship CME series. In this episode, she shares her talk with you, our One Click At A Time listeners! Using the AAFP mnemonic "The Triple Ts: Techniques, Technologies, and Transformations," she breaks down how to organize ourselves and where we can focus our attention when targeting administrative burden, whether it is through human centered design practices, stakeholder buy in for technologies, or advocacy efforts. Definitely take a listen!

Innovation is a word that is liberally used in technology spaces. Within family medicine circles, we believe that innovation is baked in to our self-perception. Bridging that gap is like leading a diplomatic mission. In a payment landscape where family medicine is the "upstream" problem to the "downstream solution," what is the innovative role of family medicine? In this episode, Kelly and Lalita break down the innovative origins of family medicine, and dissect the role that uncertainty and full-spectrum training have played in building creativity and systems thinking within family medicine.

1. Uncertainty in Medicine: Through Thick and Thin. The Nocturnists Podcast. Apr 17, 2025. https://thenocturnists.org/podcast/through-thick-and-thin

We're taking a break for the month of April, but we still want you to meet some of our incredible friends and colleagues! In September of 2024, we chatted with Chief Product Officer extrodinaire, Kalie Dove-Maguire. Take a listen!

In this episode, Kelly and Lalita chat with a good friend of the podcast, Dr. Kalie Dove-Maguire. Kalie is an Emergency Medicine physician who is now the Chief Product Officer at Evidently, an AI-enabled chart review tool. Previously, Kalie was the Senior Director of Product at Carbon Health, where she oversaw the EHR and the rollout of AI-enabled ambient documentation.

Kalie, Lalita, and Kelly chat about career journeys, innovations in the future of health tech, and ground their conversations in the practical data and human connection.

We're taking a break for the month of April, so we thought we would repost some of our spicier takes!

This episode was originally published July 16, 2024.

"Value" based care is all the rage, but as two family docs interested in data and measurability, we're not so sure. VBC will likely increase the need for informaticists and good data queries, but are proxies dictated by payers really able to capture the value of primary care? Or is qualitative research a better way to measure the immeasurable?

In this week's episode, Kelly and Lalita speak with Dr. Marisha Burden, the division head of Hospital Medicine and a professor of medicine at the University of Colorado School of Medicine and the co-creator of the mobile platform, Gritty Work. She's an avid researcher, publisher, and thought leader on evidence-based work design and building thriving teams. With a remarkable broad research base and the curiosity to creatively address research questions on optimal teams, workplace improvements for healthcare workers, and most recently, administrative harm, Dr. Burden's mixed-methods research has the potential to impact health care design in more meaningful and financially sustainable ways. An impressive conversation, this is definitely one to check out!

Show Notes:

1. Burden M, Astik G, Auerbach A, et al. Identifying and Measuring Administrative Harms Experienced by Hospitalists and Administrative Leaders. JAMA Intern Med. 2024;184(9):1014–1023. DOI:10.1001/jamainternmed.2024.1890

2. Burden M, Dyrbye L. Evidence-Based Work Design — Bridging the Divide. NEJM. 2025;392:1044-1046. DOI: 10.1056/NEJMp2412389

Alternate title: Assessment BEFORE Plan

In this episode, Lalita and Kelly speak with Esther Johnston, MD, family physician and an Assistant Professor at the University of Minnesota North Memorial Family Medicine Residency Program. She currently serves as the Director of the Global Engagement Network for Primary Health Care (GEN-PHC), a polycentric collaborative of primary care academicians that aims to facilitate the development of educational pathways, data, policies, and programs needed to support robust, fit-for-purpose primary health care systems through partnership and collaboration.

The conversation ranges from decolonizing global health in a post-pandemic world to telehealth, broadband, and building family medicine globally, this episode explores just how similar the challenges of implementing interventions (technology or otherwise) are at home and abroad.

Links to publications mentioned in this episode:

1. King NB, Koski A. Defining global health as public health somewhereelse. BMJ Global Health 2020;5:e002172. https://gh.bmj.com/content/5/1/e002172

2. Burke G, Schellmann H. Researchers say an AI-powered transcription tool used in hospitals invents things no one ever said. AP. Oct 26, 2024. https://apnews.com/article/ai-artificial-intelligence-health-business-90020cdf5fa16c79ca2e5b6c4c9bbb14

3. Website: Global Engagement Network for Primary Health Care (GEN-PHC) https://globalhealthcenter.umn.edu/genphc

Kelly and Lalita chat with Alex Butler, MD a pediatric chief resident at Boston Children’s Hospital and Boston Medical Center, and the co-founder and Chief Product Officer of River Records, an AI-powered documentation and data summarization platform. Alex received a medical degree and a Masters in Clinical Informatics from Columbia University. In this episode, the three discuss the phenomenon of a "noteless EHR," the interface goals of River Records, the influence of Dr. Lawrence Weed on clinical documentation, and how Alex has applied his interest in technology to streamlining processes as Chief Resident. A great episode for early career physicians, our show notes also include great supplementary information for our listeners!

1. 2021 Noteless EHR Paper - https://formative.jmir.org/2021/11/e23789

2. Larry Weed's 1971 Internal Medicine Grand Rounds https://www.youtube.com/watch?v=qMsPXSMTpFI

3. Digital Health Competencies - https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829788

4. Pediatric ACGME Guidelines - https://www.acgme.org/globalassets/pfassets/programrequirements/2025-prs/320_pediatrics_2025_tcc.pdf

In this episode, Lalita and Kelly speak with Col. Brian Cahill, Chief of Soldier Primary Care and soon-to-be Chief Nursing Officer at Carl R. Darnall Army Medical Center in Fort Cavazos, Texas.

As a colonel in the army with a 20-year career in clinical and administrative leadership roles, Brian discusses his journey from bedside nursing to completing a Masters degree in Clinical Informatics at Duke University to implementing MHS Genesis as CMIO at the Army Medical Center. He delves into the challenge of integrating new technologies in healthcare settings, the importance of a strong clinical background, and the role of team-based approaches in reducing risks and improving care. Additionally, Brian touches on some noteworthy help desk tickets, showcasing real-world issues and solutions.

Join the conversation to learn how innovative approaches in technology are shaping the future of primary care, emphasizing patient safety and effective healthcare delivery.