The game-changing fellowship training tomorrow's healthcare visionaries

Buckle up for an exclusive dive into the Stanford Intermountain Health Fellowship. Whether you're curious about the program's impact on patient care, its role in shaping healthcare policy, or if you're hearing about it for the very first time, you'll find answers and inspiration right here.

Hear from three leaders, Raj Srivastava, Tim Fowles, and Thea Sakata, as they unravel the unique opportunities and share personal experiences of this fellowship through Intermountain.

Raj Srivastava, MD, FRCP(C), MPH – chief clinical programs officer

How was this fellowship created and why Stanford?

The fellowship started when Stanford and Intermountain initially partnered on research projects. Over time, we saw an opportunity to connect our strengths in a more educational way. We wanted to help doctors understand not just their patients individually, but how to navigate and improve the whole system of care. The goal was to move away from the fee-for-service model, which rewards doing more, and focus on proactive, value-based care. We aimed to train physicians to prevent diseases before they happen and manage care more effectively. Stanford was really on board with this vision, and that's how the fellowship came to be.

What makes this fellowship unique? Is there something that differentiates this fellowship from others in the country?

What makes this fellowship unique is its combination of two distinct environments: a major nonprofit health system like Intermountain and a leading academic center like Stanford. Unlike many fellowships that focus solely on one institution, ours spans two years with diverse training experiences.

In the first year at Stanford, fellows gain essential skills in health system change, policy, and research, earning a Master of Public Health along the way. In the second year at Intermountain, they participate in the Advanced Training Program (ATP) which has been a cornerstone of healthcare delivery education for over 30 years, delivered by the Healthcare Delivery Institute, and engage in practical projects that help implement best practices across the system. This dual approach offers a rare blend of academic rigor and real-world application.

How are the Stanford/Intermountain fellows selected??

We’re currently on our 6th cohort. Traditionally the fellows have been chosen by word of mouth and because this fellowship is a 2-year time commitment the fellows chosen are thinking about their long-term career path.

Who would benefit the most from this fellowship??

Those who are curious about learning, self-starters, and who want to understand how complex health systems work while connecting patients to a proactive care journey.

This program allows fellows the opportunity to select projects they are interested in. The hard work and dedication required in the fellowship sets individuals up for success and many who complete the fellowship end up in leadership positions.

You mentioned earlier that each fellow participates in a project during their time at Intermountain. Does a particular project stand out from this program?

I do not have a favorite project; however, I enjoy seeing the fellows go through the coursework and arriving at their project. Many arrive with an idea, but because of the rigorous program they are each mentored and learn a great deal of new skills. Most fellows end up working on two projects.

One being a passion project, high risk and is going to take a lot of time and then a smaller project that is more definable and doable in a reasonable time frame. Observing what they do with the project and how they work that into their career has been fun to watch.

What’s an example of some of the hands-on experience that a fellow would receive during this fellowship?

Intermountain has been interested in social determinants of health, and several years ago we invested $12 million into two communities. One community was in Saint George and the other was north of Salt Lake. Both communities had poor social determinants of health. ?

One of the projects the fellows got involved in was visiting the families who were on select health insurance, who had high premiums and were being admitted to the hospital often.

The fellows went to their homes to interview the families to learn what was stopping them from getting the help they needed. They learned from patients and their families what the real barriers were and what help was needed to get the help which ultimately would keep them out of the ER. In this case we found different ways to help patients that otherwise we wouldn’t have known.

If someone was interested in this fellowship, what should they do to be considered for the program?

I think the easiest thing is just to contact me and then we can help lead them in the right direction.?

Tim Fowles, health services research director for implementation science

Tell us a little bit about yourself and how you became involved with the Stanford Intermountain Fellowship program.

I’m a clinical psychologist by training and have spent most of my career in mental and behavioral health. Prior to coming to Intermountain, I spent 13 years at the University of Delaware as a faculty member in the department of Psychological and Brain Sciences. There, I noticed a significant gap between science and practical service, so I began collaborating with others who were passionate about evidence-based practices and implementation science.

When I joined Intermountain in 2022, I shifted my focus to implementation science across all of healthcare, not just behavioral health. Now, as the health services research director for implementation science at the Healthcare Delivery Institute, I work on implementing clinical best practices, studying these implementations, and using research to enhance care at Intermountain.

One of the major things that drew me to Intermountain was the Clinical Best Practice Integration (cBPI) model, which is deeply rooted in implementation science and quality improvement. It's not only effective but also accessible and easy for non-scientists to understand and apply. ?

What projects do fellows participate on and what value do fellows bring to implementation science projects?

Fellow’s dive into a range of projects based on current needs and their personal interests. They come in with some background in implementation or quality improvement, and the top-notch training they receive at Stanford in their first year prepares them to tackle real challenges when they start at Intermountain in their second year.

The projects they work on can vary widely. For instance, former fellow Harris Carmichael, now a hospitalist at Intermountain, is doing intricate research on patient attribution across different hospitals and shifts. Another fellow, Griffin Olson, has made significant contributions and published work in various areas. Overall, fellows bring valuable insights and skills to our projects, often leading to published research and presentations at conferences.

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What value do you feel fellows bring to implementation science projects?

Fellows bring a lot of unique value to our implementation science projects, and I’d break it down into three main areas:

• Enthusiasm: Fellows come in with a fresh perspective and a contagious energy. They’re excited to tackle challenges that might seem overwhelming to those who’ve been working in the field for a long time. This enthusiasm is infectious and boosts the morale of everyone on the team and the clinical staff they collaborate with.
• Unique Expertise: Each fellow has a distinct background that they leverage to enhance their projects. For example, Thea Sakata, has a background in primary and urgent care, which has driven significant improvements in those areas. Her diverse skills help to enrich and diversify the projects they’re involved in.
• Connection to Stanford: The fellowship fosters a strong link between Intermountain and Stanford. Fellows often bring insights and techniques from their Stanford training to apply in their projects here. This ongoing connection helps us integrate cutting-edge ideas and research into our work.

The fellows’ enthusiasm, specialized skills, and their connection to Stanford are key to the success of our implementation science projects.

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What makes this partnership with Stanford unique?

This partnership with Stanford is one-of-a-kind. What sets it apart is its unique blend of cross-agency collaboration and focus on implementation science. While many fellowships involve joint efforts between institutions for clinical services—like Stanford and the VA hospital system—this one goes beyond that.

What makes it special is the fellowship integrates training and expertise from both Stanford and Intermountain. Stanford excels in theoretical models and research methodology, while Intermountain offers extensive experience with large-scale implementation across a broad patient population. Fellows get to learn cutting-edge theories and then put them into practice on a grand scale at Intermountain.

This combination of theoretical learning at Stanford and practical application at Intermountain is something I haven’t seen in any other fellowship program. It’s not just about clinical work; it’s deeply focused on the science of implementing innovative practices. This makes the fellowship quite distinct and unparalleled in the country.

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If someone was just hearing about this fellowship for the first time and interested, what advice would give them?

If you're thinking about this fellowship, my advice is to see it as a unique opportunity to kickstart a broader career. It’s ideal for those who want to push boundaries, innovate, and dive into system-level and implementation science work.

Yes, it requires a commitment—you'll need to move to Stanford for a year and take a pay cut compared to starting full-time clinical work right away. But the experience and training you’ll gain here can pay off significantly in the long run. It’s a significant investment, but if you're passionate about this field, it’s worth considering.

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Do you see many of the fellows who complete the two years staying at Intermountain?

Many of our fellows do stick around at Intermountain, especially if they had a connection here from the start. We’ve got a great track record of retaining them and helping them advance in implementation science and leadership roles. It’s part of what makes Intermountain special—always pushing boundaries and finding innovative solutions. This fellowship is a prime example of that, though it’s just one of many unique initiatives here.

Thea Sakata, Parkinson's Elevated primary care physician & implementation scientist

When did you participate in the Stanford Intermountain Fellowship?

I was a Stanford Intermountain fellow from 2021 to 2023.

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What initially made you interested in this program?

My inspiration was the realization that when you're working away in a clinic, a lot of things affecting how you can care for the patient in front of you actually happen far outside of the clinic walls. Medical school often doesn't train us to understand some of those systemic factors. I was looking for an opportunity to learn more about the context in which I was being a provider, and this fellowship seemed like the best opportunity.??

Tell us about your experience during the fellowship.

I was fortunate to be able this two-year fellowship, which is a significant time commitment when you’ve already been an attending for a couple of years! The first year at Stanford was an educational smorgasbord – it was like drinking from 1000 fire hoses. I audited as many classes as possible and also joined two research teams.

The first team was the Healthcare AI Applied Research Team, or “HEA3RT Lab,” led by Steven Lin. This team focuses on studying emerging AI technologies in clinical settings, kind of like traditional drug trials but with AI-enabled innovations instead of new medications. It was thrilling to engage with cutting-edge research and learn about creating an efficient research environment.

The second team was Sarah Singer’s HELIO Labs, which researches organizational behavior and management theory in healthcare. I worked on a project analyzing qualitative data from ICU caregivers about a technology designed to prevent pressure ulcers. This really changed my thinking around implementing technology in healthcare because getting people to use or adopt a technology isn’t enough. It’s how they’re using it that really matters.

What kind of work had you been involved with prior to the fellowship and was it a difficult decision to go back to school once you were in the workforce??

My journey began with a family medicine residency in Utah, followed by a sports medicine fellowship at the Cleveland Clinic. I was drawn back west to work at Intermountain because of its reputation for innovation around healthcare delivery. At the time, the InstaCare was hiring, so that’s where I went.

When I got here, I wanted to get involved in quality improvement projects but had a lot of difficulty finding inroads to that kind of work. I also knew that I probably needed more tools and knowledge, so I took the Intermountain Advanced Training Program (ATP) course. There, I met the first cohort of fellows in the program, and I realized that the skills they were learning were exactly what I needed to contribute more effectively to the healthcare system.

Going back to school after being in the workforce wasn’t a tough decision because it was a clear path to being able to some of the work that I wanted to do. For me, the value of gaining new skills and insights was clear.

Also, having worked for a few years as a clinician before doing this particular fellowship was particularly valuable because I could provide a clinical perspective to research projects and conversations with healthcare entrepreneurs and disruptors.

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What was your favorite part of the fellowship experience???

There were a couple of things that really stand out. First, I loved having the opportunity to learn new skills and apply them to what I already knew about healthcare. For example, Stanford has a wonderful institute of design (aka D-school), where some of the courses and workshops focus on healthcare. Even before doing the fellowship, I had been a fan of design thinking, but I couldn’t figure out how to apply it in my work. The classes I took through the D-school helped bring pieces together and bridge the gaps for me.?

The other part of the fellowship that stands out was meeting people doing incredible things in healthcare. I was a teaching assistant for a social entrepreneurship lab, where I worked with undergrads and grad students on some very innovative projects. For instance, one MBA student was looking at how a new business model for forestry could help reduce wildfires and their health impacts, while an engineering student was developing a new method to detect diabetic foot ulcers in the developing world. It was inspiring to be part of such forward-thinking work and see the creative solutions people were coming up with.

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Could you describe the project you worked on during your fellowship?

I actually worked on two! One was at Stanford, and the other was here at Intermountain. The Intermountain project was called Urgent Care ePneumonia. It’s an initiative that started with Nat Dean, a well-known pulmonology and critical care doctor here who had already made significant strides with a tool for improving pneumonia care in emergency departments. This tool helped ensure that patients needing admission were admitted, while those who didn’t were safely sent home.

Dr. Dean wanted to adapt this tool for urgent care settings, and I was a late addition to his team, whose work was already well under way. I think Raj Srivastava, my fellowship advisor, matched me to this project because of my interests in implementation science and learning about AI. For the ePneumonia adaptation for urgent care, Nat was integrating new AI tools into the project: one that could give preliminary X-ray reads on whether a patient had pneumonia, and another tool for risk stratification based on a patient’s EHR data.

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How has completing the fellowship influenced your career? Has it made a significant impact?

The fellowship has had a significant impact on my career. After returning to Intermountain, I wanted to move away from a purely clinical role and explore other areas. I took a position as the primary care doctor in a program called Parkinson’s Elevated, where I could leverage my skills in quality improvement, design, implementation science, and research.

Parkinson’s Elevated was conceived by Kathleen McKee, a movement disorders neurologist also here at Intermountain. She aimed to improve care for Parkinson’s patients by integrating high-intensity exercise into their treatment—a concept backed by clinical research but not yet implemented in real world settings. Dr. McKee also hypothesized that Parkinson’s patients would benefit from a model of healthcare delivery based on Michael Porter’s work, called an Integrated Practice Unit (IPU). With the skills developed in this fellowship, I can help implement and study all of this.

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If you hadn't participated in this fellowship, do you think you'd be where you are today?

No, I definitely wouldn’t be where I am today without the fellowship because I probably otherwise would have had to leave the state! Before meeting the first cohort of fellows at ATP, I was toying with a lot of ideas such as, getting an MBA or looking for an MHA program elsewhere because I realized that I couldn’t solve the bigger issues from a purely clinical role. I knew I needed to look at healthcare from a systems level to make a real impact, but those other types of programs didn’t align completely with the type of education I was looking for. This fellowship ticked all the boxes on the knowledge and perspectives I needed. It turned out to be the perfect opportunity!