At any given time in the afternoon, a doctor might be sitting next to an engineer in a building on Stanford’s Palo Alto campus, and a data scientist might be in the next room running analytics on client outcomes. It’s not a tech company. It’s medicine, or more accurately, a new version of what medicine wants to become.
DREAM stands for “Division for Research and Education in Academic Medicine.” It was officially launched by Stanford’s Department of Medicine on September 1, 2023. It put six centers and programs that were already in place under one administrative roof. On paper, that might not sound very exciting. It’s harder to ignore, though, after taking the time to see what those programs do.
DREAM is not organized like most school divisions are. It doesn’t fit neatly into any one field or specialty. Engineering, management, digital health, clinical research, and what Stanford calls “bedside medicine” are all part of it. This is a term that sounds almost radical in this age of screens and algorithms. One of the most well-known projects in the division is the Stanford Medicine 25 program, whichs only goal is to bring back the art of physical examination. Every day, thousands of people interact with it online. Given the direction medicine seems to be going, that seems almost countercultural.
The Center for Digital Health is also located in DREAM. This group works on AI applications in healthcare, mental health technology, and solutions for populations that are getting older. When you put together the old skill of the physical exam with machine learning and digital diagnostics, you might feel some tension. That being said, the tension could also be the point. At that point, some of the most interesting medical thinking is happening right now, and Stanford seems to be betting that putting it all together will lead to something more useful than putting it in separate rooms.
There is something special about the Clinical Excellence Research Center, which is another part of DREAM. It’s being called the first university-based center in the US whose sole purpose is to create cost-saving innovations in healthcare—not just clinical breakthroughs, but ones that can be used right away and won’t break the bank. How you frame it matters. For a long time, American healthcare has been great at coming up with expensive solutions. It has become much harder to find treatments that are both clinically sound and budget-friendly. The question of whether CERC can make a difference is still open, but the fact that it is being tried at a major university seems important.
In her role as interim department chair, Bonnie Maldonado called the launch “an exciting moment” and said she was sure that DREAM would make the programs within it better. It’s easy to be skeptical of that kind of language because administrators often talk about exciting events. But the way this is put together makes it look like more than just a rebranding exercise. The Translational Research and Applied Medicine Center (TRAM) was created to bridge the gap between lab discoveries and real-world patient care. This gap has been suffocating a lot of promising research for decades. The M-TRAM master’s program teaches clinicians and researchers how to bridge that gap in the real world, not just in theory.
As I watch this all come together, I get the sense that Stanford is trying to solve a problem that most medical schools haven’t quite named yet: the growing gap between what medicine knows and what it does with that knowledge, as well as the gap between the human side of care and the direction that technology seems to be taking everything. It’s really not clear if DREAM will have as big of an impact as its goals suggest. However, it’s impossible to miss the fact that someone is at least trying to understand.
