Dr. Matthew Strehlow:
Every year, the Stanford Emergency Medicine Innovation Symposium, also known as StEMI X, brings together leaders and innovators from healthcare, education, and industry to explore what’s possible in the future of acute care.
In this episode, conference director Dr. Ryan Ribeira joins us to reflect on the themes, breakthroughs, and energizing ideas that stood out at this year’s symposium. Dr. Ribeira is an emergency physician and healthcare innovator whose work spans clinical operations, digital health, and system-level redesign.
In addition to his leadership at StEMI X, he’s also the medical director for the adult emergency department here at Stanford and founder of the Stanford Emergency Medicine Partnership Program. Dr. Ribeira—Ryan—welcome.
Dr. Ryan Ribeira:
Thanks so much for having me.
Dr. Matthew Strehlow:
I appreciate you joining me for this conversation.
First question. I know you have a million responsibilities. I listed three out of about 3,000. It’s always amazing to see how much you pack into your days. Is today more tech-driven or more caffeine-driven?
Dr. Ryan Ribeira:
It’s always a little bit of both. Fueled by Red Bull, the cultural drink of emergency medicine, and enthusiasm for the future of acute care. That’s part of what keeps me running.
Dr. Matthew Strehlow:
Ryan, this was the fifth year of StEMI X, but your path into innovation and technology started long before this conference existed, even before I met you. Can you take us back a bit? Where did this interest and passion for innovation and technology begin?
Dr. Ryan Ribeira:
Some of it goes back to undergrad. I was a computer science major at first, then switched into accounting, then into business management and entrepreneurship.
I was already on the emergency medicine route with my varied and always-changing interests. I was most of the way through that before I even realized I wanted to go to med school. By the time I decided to go to med school, I was already very technology- and entrepreneurship-oriented.
While I was doing my pre-reqs for med school, I worked for an angel investor, consulting on early-stage technology companies. By the time I went to med school, I knew this was something I was going to be interested in.
I was part of a number of different health tech startups in med school. Almost all of them collapsed, but that’s the nature of it.
In my fourth year of med school, I started SimX, a virtual reality medical training company that I founded, which has now grown into an industry-leading company in that field.
Along the way, I had pit stops at the American Medical Association. I was on their board when we founded the AMA Venture Fund and wrote the Digital Health Playbook. I also had a pit stop at Google as a program manager for health search, providing medical input related to diagnoses and symptoms.
I was “Doctor Google” for a bit, which maybe I shouldn’t say out loud. It’s a hard job—harder than it seems. We did our best.
I don’t think there was any one particular early experience. But throughout all of this, I noticed how starved technology companies are for clinical input. They have great ideas, phenomenal engineers, and strong business leadership, but they don’t really understand how the clinical side works.
On the flip side, in academia, we have talented researchers and clinicians who know healthcare deeply but don’t always know how to translate innovations into products.
As I started my career as a faculty member here, it became clear that part of what I should try to do is bridge that gap—bringing academic insight to industry and industry insight back to academia—so we can work together to build a better future.
Dr. Matthew Strehlow:
What drives you to want to fill that gap? With everything you’ve done, what drives you to focus your energy there?
Dr. Ryan Ribeira:
When we look at the big problems in healthcare, a huge proportion of our GDP is taken up by healthcare expenses, and many people find it unaffordable.
I’ve done a lot of work in the policy space. Healthcare policy is important, but it’s unlikely to make healthcare dramatically more affordable and accessible on its own. We need change on the order of 80%.
The kinds of solutions that tend to have that level of impact are technology solutions. If we’re going to make healthcare accessible and affordable for everyone under all circumstances, it’s going to require technology change.
But if technology isn’t used or implemented correctly, we risk repeating problems we’ve seen with EMRs, where they sometimes work against us as much as they work for us.
With AI, telemedicine, and related technologies, there’s a huge opportunity to improve affordability and access. But it needs to be informed by the bedside perspective, by clinicians, and by academia committed to building a patient-centered future—not one driven exclusively by profit.
That’s why it’s urgent to bridge this gap. We need the bedside perspective embedded in what’s happening in industry now.
Dr. Matthew Strehlow:
I came to a similar conclusion through global health work. Early on, I thought innovation and technology weren’t the answer. Over time, I realized innovation is the only way to bridge access and affordability gaps. You have to leapfrog—you can’t move one step at a time.
Dr. Ryan Ribeira:
Yeah.
Dr. Matthew Strehlow:
Turning to StEMI X, technology in healthcare is evolving incredibly fast. What was your vision for this year’s conference?
Dr. Ryan Ribeira:
Our hope was that StEMI X could be a one-stop shop for getting up to speed on emerging technologies within acute care—and ideally, ahead of the game.
What are people doing right now? What can you realistically be ready for in the next one to two years? That’s about as far as you can predict anything at the moment.
We also wanted it to be a real meeting of the minds—bringing together industry, academia, and community, and letting them bounce ideas off one another. That’s why the conference was panel-heavy.
Thematically, it’s clear we need to think beyond the walls of the emergency department. It’s not care anytime, any place, anywhere—it’s the right care, at the right time, in the right place.
That starts when patients first consider seeking care and extends through the post-ED journey. That’s why the theme was “EM Without Walls: Innovating Across the Acute Care Continuum.”
If emergency medicine doesn’t own that continuum, nobody will. There’s important work to be done to ensure patients are directed appropriately and receive the follow-up they need.
Dr. Matthew Strehlow:
What stood out to you during those conversations? Were there areas of opportunity or friction?
Dr. Ryan Ribeira:
One example was a panel on preventing unnecessary ED visits. We discussed using remote patient monitoring to shape the journey toward acute care, even before patients realize they’re about to seek it.
One panelist described using cell-phone-based technologies to analyze conversations for signs of mental health deterioration and intervene before a crisis occurs. That came up across multiple panels.
Wearables were another recurring topic. There’s untapped opportunity to bring wearable and home RPM data into acute care decision-making, but we lack standardized data structures, EMR integration, and reliability signals for clinicians.
That friction highlighted the need for cross-collaboration to integrate these data streams into our clinical informatics infrastructure.
Dr. Matthew Strehlow:
Is it possible to advance these technologies when reimbursement models lag behind?
Dr. Ryan Ribeira:
We need innovation in business models and reimbursement as much as innovation in technology.
Telehealth is a good example. The technology existed for decades, but adoption exploded once reimbursement aligned. There’s a risk that enthusiasm around AI and remote patient monitoring could stall without viable business models.
That’s why industry needs clinical input—figuring out who buys these tools and why is one of the hardest problems to solve.
Dr. Matthew Strehlow:
Even simple examples show this gap. I recently cared for a patient with syncope who had an Apple Watch. I reviewed the ECG, heart rate, and oxygen saturation during the episode. It took time, but it changed my decision-making.
There’s no reimbursement model for that yet. If I print a rhythm strip, we get reimbursed. That lag is slowing progress.
During the pandemic, once barriers were removed, telehealth and digital health exploded because patients wanted it and clinicians could deliver it.
Dr. Ryan Ribeira:
Acute disasters move people quickly. Slow-motion disasters, like what we’re experiencing in healthcare, are harder to mobilize around—but that’s our job.
Dr. Matthew Strehlow:
Where do you think academic–industry partnerships are heading? Are they true collaborations, or are we a means to an end?
Dr. Ryan Ribeira:
We may be a means to an end, but it’s still valuable.
I am concerned that partnerships may be weakening as large technology companies build robust internal research arms. Cutting-edge research increasingly comes out of industry.
If academia doesn’t demonstrate its value—or becomes overly restrictive around data sharing—we risk losing influence over the future of health technology.
Dr. Matthew Strehlow:
Industry research often looks good on paper but hasn’t been tested in the real world.
Dr. Ryan Ribeira:
It’s the in vitro versus in vivo distinction. We control access to real patients, and that matters.
Dr. Matthew Strehlow:
What’s one technology every emergency clinician should be paying attention to?
Dr. Ryan Ribeira:
AI.
Large language models can turn unstructured EMR data into structured data, enabling predictive algorithms that weren’t possible even two years ago.
Departments that develop fluency early will be better positioned as this becomes universal.
Dr. Matthew Strehlow:
AI builds on decades of groundwork—EHRs, big data, and compute power.
Dr. Ryan Ribeira:
AI may be our best candidate for making healthcare dramatically cheaper and more accessible—but only if we do it right.
Dr. Matthew Strehlow:
You’re known as one of the most entertaining presenters in our organization. What’s your secret?
Dr. Ryan Ribeira:
Storytelling. Thinking about the emotional journey of the audience—how they feel slide to slide—and adjusting tone and data accordingly.
Dr. Matthew Strehlow:
That’s a wrap for today’s episode. Thanks to Dr. Rivera for sharing his insights.
For those listening, be sure to check out the show notes for links to his work. This year’s StEMI X session recordings are available for viewing and CME on the ASEP Anytime platform.
If you liked today’s episode, subscribe and share it with a colleague. Thanks for tuning in.
(lightly edited for brevity and readability)
