Keith Morse, MD, MBA, is a pediatric hospitalist and Medical Director of Clinical Informatics at Stanford Medicine. His work in operational and research informatics focuses on meaningful deployment of machine learning in clinical settings. He completed a fellowship in Clinical Informatics at Stanford.
Clinical Assistant Professor, Pediatrics
Medical Director of Clinical Informatics, Stanford Children's Health (2020 - Present)
Board Certification: American Board of Pediatrics, Pediatrics (2018)
Residency: Phoenix Children's Hospital Pediatric Residency (2018) AZ
Medical Education: Jefferson Medical College (2015) PA
Fellowship, Stanford University, Clinical Informatics (2020)
Residency, Phoenix Children's Hospital, Pediatrics (2018)
MD, Jefferson Medical College (2015)
MBA, Washington University in St. Louis (2009)
Digital Symptom Checker Usage and Triage: Population-Based Descriptive Study in a Large North American Integrated Health System.
Journal of medical Internet research
BACKGROUND: Pressure on the United States (US) healthcare system has been increasing due to a combination of aging populations, rising healthcare expenditures and, most recently, the COVID-19 pandemic. Responses are hindered in part by a reliance on a limited supply of highly trained healthcare professionals, creating a need for scalable technological solutions. Digital symptom checkers are artificial intelligence (AI)-supported software tools that use a conversational "chatbot" format to support rapid diagnosis and consistent triage. The COVID-19 pandemic has brought new attention to these tools, with the need to avoid face-to-face contact and preserve urgent care capacity. However, evidence-based deployment of these chatbots requires an understanding of user demographics and associated triage recommendations generated by a large, general population.OBJECTIVE: In this study we evaluate the user demographics and levels of triage acuity provided by one symptom checker chatbot deployed in partnership with a large integrated health system in the US.METHODS: Population-based descriptive study including all online symptom assessments completed on the website and patient portal of the Sutter Health system (24 hospitals in Northern California) from April 24th, 2019 to February 1st, 2020. User demographics were compared to relevant US Census population data.RESULTS: A total of 26,646 symptom assessments were completed during the study period. Most assessments (17,816/26,646, 66.9%) were completed by female users. Mean user age was 34.3 years (SD: 14.4 years), compared to a median age of 37.3 years of the general population. The most common initial symptom was 'abdominal pain' (2,060/26,646, 7.7%). A substantial portion (12,357/26,646, 46.4%) was completed outside of typical physician office hours. Most users were advised to seek medical care the same day (7,299/26,646, 27.4%) or within 2-3 days (6,301/26,646, 23.6%). Over one quarter of assessments required a high degree of urgency (7,723/26,646, 29.0%).CONCLUSIONS: Users of the symptom checker chatbot were broadly representative of our patient population, though skewed towards younger and female users. Triage recommendations are comparable to those of nurse-staffed phone triage lines. While the emergence of COVID-19 increases the enthusiasm for remote medical assessment tools, it is important to take an evidence-based approach to their deployment.CLINICALTRIAL:
View details for DOI 10.2196/20549
View details for PubMedID 33170799
- Estimate the hidden deployment cost of predictive models to improve patient care. Nature medicine 2020; 26 (1): 18–19
Your Patient Has a New Health App? Start With Its Data Source.
Journal of participatory medicine
2019; 11 (2): e14288
Recent regulatory and technological advances have enabled a new era of health apps that are controlled by patients and contain valuable health information. These health apps will be numerous and use novel interfaces that appeal to patients but will likely be unfamiliar to practitioners. We posit that understanding the origin of the health data is the most meaningful and versatile way for physicians to understand and effectively use these apps in patient care. This will allow providers to better support patients and encourage patient engagement in their own care.
View details for DOI 10.2196/14288
View details for PubMedID 33055064
View details for PubMedCentralID PMC7434101
Hospital-Level Variation in Practice Patterns and Patient Outcomes for Pediatric Patients Hospitalized With Functional Constipation.
2017; 7 (6): 320–27
Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals.We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System. Patients were included by using constipation and other related diagnoses as classified by International Classification of Diseases, Ninth Revision. Patients with complex chronic conditions were excluded. Outcome measures included percentage of hospitalizations due to functional constipation, therapies used, length of stay, and 90-day readmission rates. Statistical analysis included means with 95% confidence intervals for individual hospital outcomes.A total of 14 243 hospitalizations were included, representing 12 804 unique patients. The overall percentage of hospitalizations due to functional constipation was 0.65% (range: 0.19%-1.41%, P < .0001). The percentage of patients receiving the following treatment during their hospitalization included: electrolyte laxatives: 40% to 96%; sodium phosphate enema: 0% to 64%; mineral oil enema: 0% to 61%; glycerin suppository: 0% to 37%; bisacodyl 0% to 47%; senna: 0% to 23%; and docusate 0% to 11%. Mean length of stay was 1.97 days (range: 1.31-2.73 days, P < .0001). Mean 90-day readmission rate was 3.78% (range: 0.95%-7.53%, P < .0001).There is significant variation in practice patterns and clinical outcomes for pediatric patients hospitalized with functional constipation across US children's hospitals. Collaborative initiatives to adopt evidence-based best practices guidelines could help standardize the hospital management of pediatric functional constipation.
View details for DOI 10.1542/hpeds.2016-0101
View details for PubMedID 28522604