Edward Kim
Clinical trials really create opportunities for people, opportunities of hope, so that we can try to improve on the current standard of care. I challenge the faculty I've recruited, the faculty at City of Hope, in that I don't want to practice the standard of care. Now, when you hear that out of context, you're like, whoa, what's wrong with this guy?
Matthew Weinstock
That was Edward Kim talking about his vision for the future of cancer care. Kim is the Physician-in-Chief at City of Hope Orange County and Vice Physician-in-Chief of City of Hope National Medical Center. The Comprehensive Cancer Center was founded in 1913 near Los Angeles. Its reach has since grown to Atlanta, Chicago and Phoenix. And in December 2025, City of Hope expanded its footprint in Southern California when it opened a campus in Orange County.
The new hospital not only brings cancer care to a larger patient population, but enables City of Hope to continue what Kim says is its mission of speed, scale and serve. That's the idea of offering clinical trials quicker and to more people in more communities.
In this podcast, Kim and Oliver Wyman's Igor Belokrinitsky discuss some of the challenges and opportunities facing cancer care, including not just bringing the bench to the bedside, but the bedside to the bench. The Oliver Wyman Health Podcast is brought to you by the global management consulting firm Oliver Wyman. For more insights on the business of transforming healthcare, visit our online publication, health.oliverwyman.com.
And now let's pick things up with Kim discussing his background and what led him to a career in cancer care.
Edward
I grew up in Terre Haute, Indiana. If you don't know where that is, it's where Larry Bird played his college ball at Indiana State University. My father was a finance professor, and he spent 26 years there teaching finance and awarding MBAs and bringing those folks into the workforce. My mother was a master of fine arts, you know, a lot of painting, a lot of sculptures, a lot of metalwork, very talented. I actually thought I would be an engineer who designed cars. That's what I felt like I would do when I was growing up. And I was in art shows and illustrated comic books and those types of things.
You know, we all have stories to share. When I was in eighth grade, I was 14 years old. My younger brother, Donald, suddenly passed away at age 12. He died of Kawasaki syndrome, which really goes undiagnosed, and it really doesn't harm many people. When you're an infant, you get a viral illness, which we call scarlet fever. I remember he was in the hospital for about a week, and no issues from there. You know, I just grew up a normal childhood like any kid would do, played all sports, no label of any type of disease, but unfortunately, I had a late-stage manifestation of arterial aneurysms that occurred. He died suddenly at a skate party. From that day on in eighth grade, my entire mission changed in my mind. I wanted to pursue medicine. I wanted there to be more access.
Terre Haute, Indiana, at the time didn't really have large access to big academic centers. There were certainly a lot of physicians in the area. And so I pursued medicine and ended up going to Northwestern. Four months into my residency, I discovered oncology. I did an oncology rotation, and I thought the patients were just unbelievable. Now I had zero interest in oncology, maybe negative 10 interest in oncology, going through medical school. But I thought, wow, these people are amazing because they're so brave, they understand now that each day, each minute is precious, and the whole perspective of the conversation with these patients, it really puts reality into perspective.
Igor Belokrinitsky
Thank you for sharing your story. I would love to hear now that we have your thoughts on what is happening now at the frontier of cancer care, because you are on that frontier, you're sort of pushing that frontier and what you're doing on that front, both locally and regionally in Orange County, as well as nationally in your role as the director of clinical trials nationally.
Edward
Yeah, clinical trials really create opportunities for people, opportunities of hope, so that we can try to improve on the current standard of care. I challenge the faculty I've recruited, the faculty at City of Hope, in that I don't want to practice the standard of care. Now, when you hear that out of context, you're like, whoa, what's wrong with this guy? But think about it, the standard of care is what we did yesterday. We were able to keep improving it, but it's still what we did yesterday. I want to try and bring treatments that are the treatments of tomorrow to people, and this is how we do it through clinical trials. And these days our drugs are getting smarter, they're getting better, people are having fewer side effects, so how do we do that? Well, we know that there are a lot of hurdles in finding clinical trials and opening clinical trials. Let's look at the perspective first from the physician and the investigator. You've got to go through multiple committees. You have to go through the IRB, which is important because it's about patient safety, and review committees. If you're trying to get a grant, you have to secure the grant funding and then go through. It can be a long journey.
What we have at City of Hope is we're able to identify trials and activate them in less than 90 days. That's number one. That's the speed aspect. Number two is, can we actually open it more than just at a single center? And that becomes logistically tough, even for sites that are maybe 10 minutes away, 30 minutes away, let alone multiple states away. And then who are we going to treat?
I like to call it speed, scale, serve. That is our mission in the clinical trials office. Our North Star is to give every patient who comes to our door the opportunity to participate in a clinical trial, because not everyone will be eligible, but at least they have had the opportunity. We're the only system in the country now, academic system, that can open a trial simultaneously at up to all 40 of our sites across four states. That means if we activate a trial later today, it could be activated in California, Illinois, Georgia, and Arizona. That's something that we take very seriously, is that scale aspect. If we don't have a trial open at one of these sites and we identify a patient, we can actually activate that study within two weeks.
So it's a just-in-time model. And then serve. Who are we serving? We are serving the people of these communities. So whether we open it at one of our large campus sites in a metropolitan area or we open it in a small site that's in a rural part, if we have a site there, we can activate that study. We want to continue to bring more opportunities, more trials, and the great part, Igor, is that before we could only bring cutting-edge trials, especially in many of the tumors, in the late stages. That's where drugs were being tested.
Now we can bring these same drugs to the locally advanced and early stages. That means if we're able to identify those patients earlier through our screening and prevention studies, treat their cancer at an earlier stage with better drugs, less toxic, improved efficacy, we're going to cure more people. We want to produce more survivors who can not only just survive, but thrive in their lives and create a new patient who has put cancer behind them, but now is an advocacy force out there to really get other people to understand that clinical trials and research are important areas for them to explore with their doctors, no matter where they live.
Igor
That is so compelling. I love the framing of speed, scale and serve. I love this future of cancer care that is more precise and individualized, and also happens earlier, happens more upstream. And it's very interesting to me that you're kind of on one hand using the language of precision and individual approach and access, and on the other hand, very industrial language around scale and just in time, and they need to do both of those things at the same time.
As you think about City of Hope Orange County and how it was planned and designed and built and how it's run today, to what extent are you seeing the speed, scale and service represented in the facility and the services that it offers?
Edward
Yeah, the Orange County movement was not one taken very lightly. It takes guts, frankly, to open a second campus 35 miles from your home base. Doesn't seem like it's a good strategy because you might have patients make a choice, and you might actually decrease your volumes at one or the other.
In fact, it was quite the opposite. Almost 20% of the diagnosed cancer population in Orange County was leaving the county for care. Now, maybe they were going to LA, San Francisco, but maybe it was Houston, maybe it was Chicago, maybe New York. That told us there was a need. So that's number one. Go to who your customer is, who your front line is, and see if there's a need. It seemed like there was. Number two, what kind of uniqueness can we bring?
We're one of only five centers in the country that just focus on cancer. We don't deliver babies. We don't fix hips. We can be singularly minded, focused on cancer. And we really advanced care quickly here. We've put the campus up very fast. Again, hired an additional 40 doctors for our outpatients, an additional 55 for our inpatients. So I have over 100 physicians, experts in cancer, all under one roof in less than four years. Again, we're over 40,000 patients served.
Our business plan, when we put it out, you know, eight to 10 years, we're three to four years ahead of schedule. These are both good from a business plan standpoint. But it's challenging because it means the need is so increased and so much appreciated. We have been welcomed to this neighborhood. We came in to be good neighbors. We know there are other hospital systems here, and we want to just lift all the boats so that everything can rise, and I think the people of Orange County have been served very well by not only City of Hope coming to Orange County, but also the other systems have also really stepped up to try and help folks in the area.
I think it's been very exciting and rewarding. We hired over 500 nurses for the hospital, so again, they are frontline workers for us and are physician extenders. We've also launched new types of programs in research. We do pancreatic cancer screening, gastric cancer screening, and we'll be opening up a thyroid cancer screening study pretty soon. Why? Because we have a very diverse community here in Orange County with a Latino population, an Asian population, et cetera. So we need to make sure that we are sensitive to the people who live around us and what is happening in their cancer journey. We know from the American Cancer society that the younger, under age 50, we're seeing increases in cancer incidence. That means you are going to be left out of most of our standard screening guidelines. Age 45 for colon cancer, age 40 for breast cancer, and those are still pretty recent. Big arguments over 40 versus 50 for breast cancer. 50 to 45 just recently. I know this because I got my colonoscopy at 49 and 11 months. And I thought, yeah, I was one month early. And sure enough, within a year, they dropped the guidelines to 45. So now was I five years late or one month early?
We can open up research studies that allow people to receive screening and prevention and treatment outside of what the standard guidelines are. And this is how we're going to move the needle forward.
Igor
I'm very curious about the balances and the trade-offs that you make, because every minute there's more demands on your time. You're making trade-offs as an individual, as an executive, and then City of Hope is making choices and trade-offs with these unlimited needs and limited resources, choosing whether to focus more nationally and globally or locally. In research, focusing more fundamentally or closer to the bedside, choosing to think about more high-tech or high-touch, choosing between research, teaching and clinical and community. All of these trade-offs come up every moment. How do you think about them? How does City of Hope think about them?
Edward
We always start with what our North Star is, and that is, what can we do to best help patients? And we know that there are disruptors that occur. The COVID-19 pandemic was a big disruptor. But guess what? We adapted. We were able to implement telehealth. We were still able to enroll people into research studies. And I think those types of things force us to redesign, reimagine what our care is. There are always positives you can pull out of that, whether it's economic pressures that occur, it forces us to look at redesign.
Now I'll bring it up, AI. I don't know what minute in the segment we're at, but I'll bring it up. That's the first time I've noted it in every meeting when AI first comes up. AI is something that can be a very strong partner and supplement to what the physician does or what the healthcare worker does. If it drives efficiency, meaning fewer person-hours needed, but enhancing the abilities of those people, that's the way we look at it. I don't think we'll ever replace the need for human contact.
I think more than ever, people need to be talked to. They need to have a conversation. They need compassion, empathy and understanding. Our science, our research, we know absolutely has to go forward because that's what's going to make the biggest changes to our field, to the care of patients. The more lives we can touch with updated information, education, research and expertise, the better. Make sure you do your biomarkers whenever you're being evaluated, because that is what can drive better therapy and better research opportunities. This is really foundational to City of Hope. I don't feel like they're trade-offs. I feel like it's the pursuit of excellence with as much speed as possible. We know that through that journey, we're going to affect more people.
Igor
I love the message that some of these constraints we have are an invitation to be innovative and resilient and nimble and continue reinventing. And maybe in that spirit, you know, you've worked in several different institutions. As you think in particular around academic institutions that have missions of care, innovation and teaching, how do you see them changing themselves and reshaping? I think the traditional model was being a destination, and everybody comes to you for your very cutting-edge care. How does that change in the future?
Edward
It's really a cultural mindset. You have some people who are very scientific in the lab, driving basic science research, different pathophysiology and biology to lead toward new pathways that are being discovered. You have clinician scientists who spend half their time in the clinic and half of their time in the lab, and they're trying to bring forward new therapies to translate what we're seeing in people and how that can be related to the bench. So you hear these sayings like bench to bedside. Equally important is bedside to bench. And that's the thing that you learn. It is a circular model where both sides share their experiences and find ways to move forward.
And then you have the general oncologist who is on the front line, who is not necessarily an expert in one particular area, but has to have a knowledge of many different cancers. Those folks are so important because 80 to 85% of our population is being seen by those folks. Empowering them to have clinical trials at their fingertips, to have pathways and expertise that they can either find or contact, is so important to deliver that care. The sooner that this cultural shift occurs, where you can have these centers of excellence with experts who are Nobel laureates and parts of the academy, it is very important, but how they can distribute their knowledge, their expertise, and bring that forward to the front line.
I don't wanna say it's the model of the future because we're already doing it right now and we've done it at other centers, but more of them need to adopt this philosophy. Because just as you say, Igor, the days of traveling long distances to go to a destination center are really only for a few percentage of folks now. Most people are comfortable where they grow up, where they live, where their community is and where their support is. We know that technology exists to allow connectivity and minimize the amount of travel that's needed. The best systems are one that blend both a strong academic focus, research focus, being comprehensive, getting the grants that we need, but also combining that frontline experience, that frontline caregiver who is able to deliver that expertise and deliver and give options of clinical trials to that patient who lives in the community.
And that's going to be a very important flex that needs to occur across our culture so that we can extend that expertise. I want everyone to get screened. I want everyone to have the opportunity to get genomic testing. And we can do this. It just needs to be now active.
Igor
As we bring the conversation to a close, it's been a phenomenal conversation and full of insights and hope and very much appreciated. You mentioned the importance of the human touch, of the human connection, of personalized care, and you also brought up the role of AI and the importance of that going forward. I'm curious how you're thinking about the role of AI in all your many roles, including as a leader of a group of clinicians, many of whom, as you said, are new. We know clinician demographics are changing. So, how are you thinking about the role of AI in cancer care in the job of the physician going forward?
Edward
Yeah, so broad topic, but I'll try to center it on several perspectives. One is that being a physician these days is getting less satisfying. There's a long training period, and the number of administrative burdens that are placed on a practitioner, I think, is tipping the scales the other way. There are way too many regulations around notes and orders and all those things that, yes, are very important parts of care of the patient, but are less direct in the care.
We should be using AI or any type of natural language processing to dictate notes and generate notes for folks. Orders should also be able to be populated in a very smart way. This would cut down hours and hours each week for providers and free up their time to add more patients and see more because that's the satisfaction we get is helping people through the human touch, not typing notes for several hours a day and then reviewing them and having to sign off on them. So that's a very easy win. And I think we just need to loosen some regulatory hurdles around that.
The next step is obviously prior authorizations, and the way we have to go to payers. And again, a very important part of care, but there could be AI that helps make those decisions more streamlined. You shouldn't have to argue the same test that's being done two months later in the same patient. It should really be a smart app that allows that, and it and could be screened. So more automation around that as opposed to escalating and having to hold on the phone for lots of time.
How can we look at it from a system standpoint? We have lots of data. And the problem in a lot of healthcare areas has been the lack of structure around data. More institutions are structuring fields of data so that it is usable data and not one that has to be sorted too much. If we can get that data, we can now create efficiencies in how patients' appointments are, how the workflows go and how to streamline even ORs and cases or infusion. There are so many applications that these types of tools can help us with. And then also in the clinical trials area, can you imagine a day where you don't have to search through long lists to find a trial, let alone not have an understanding of it? It's amazing some of these tools that we use online that give you the summary of so much information.
So you can see this applicability that could come forward for the frontline clinician, for the patient from their side to understand what a clinical trial is, what this one is, and whether it fits them based on characteristics. We also use an AI program to identify across our huge national footprint where the patients are based on eligibility for their clinical trial. So we can see geographically where they are, and that helps us supplement what our physicians think about where to open these studies, because more of these patients may be present in those communities.
So there are so many utilizations of AI. I think we are just trying to wait for the tools to mature and really be more accurate. But I'm very optimistic that AI will complement many things that providers do, everything from radiology and pathology to the day-to-day work that becomes very onerous. I hope it brings new energy for the patients and empowers patients on the other side to really seek out answers. And I think if we can achieve that with AI in the medical field, then we've accomplished a lot.
Igor
Your optimism is very evident and very contagious. Your message of hope, backed up by cutting-edge science and medicine, delivered in a great and accessible setting, is a very compelling message. The notion of speed, scale, and serve is a great, great message again going forward for healthcare institutions as they consider their future missions and strategies. So, really appreciate this conversation. Really appreciate all the great work you're doing. Thank you so much.
Edward
I appreciate you taking the time, Igor. It was great to meet you.
Matthew
Thank you for listening to the Oliver Wyman Health Podcast. This podcast is brought to you by the global management consulting firm, Oliver Wyman. For more insights on the business of transforming healthcare, visit our online publication health.oliverwyman.com.
This transcript has been edited for clarity.
