About
Titles
Associate Dean, Digital Strategy & Transformation, Office of the Dean, YSM; Professor in Biomedical Informatics & Data Sciences, YSM; Professor of Neurology, YSM; Senior Vice President & Chief Digital Health Officer, YNHHS
Biography
Dr. Lee H. Schwamm, MD is Associate Dean for Digital Strategy and Transformation for Yale School of Medicine, and Senior Vice President + Chief Digital Health Officer for Yale New Haven Health System. In this role, he is leading the development of a new digital health strategy for the school and the health system, and serves as an influential physician leader and an agent of change to catalyze the equitable adoption of virtual care and digital enablement throughout the enterprise.
Before joining Yale, Dr. Schwamm spent 3 decades of service at the Mass General Brigham Health System in academic and administrative leadership roles. He was the inaugural C. Miller Fisher Chair in Vascular Neurology, Executive Vice Chair of Neurology and Director of the Center for TeleHealth at Massachusetts General Hospital; Vice President for Digital Patient Experience and Virtual Care, and Chief Digital Advisor for the Mass General Brigham Health System, and a Professor of Neurology at Harvard Medical School. He oversaw all systemwide virtual care and telehealth activities including synchronous and synchronous virtual visits and consults, remote patient monitoring, virtual urgent care and online second opinions. During the first 6 months of COVID, he led adoption efforts for 10,000 clinicians to provide over 1.7 M virtual visits, and introduced a suite of innovative inpatient virtual solutions.
A graduate of both Harvard College and Harvard Medical School, he completed residency training in neurology, and fellowship training in stroke and neurocritical care, all at Massachusetts General Hospital where he subsequently joined the faculty in 1996. He has spent the past 2 decades in telehealth, as a pioneer in telestroke and a leading advocate and policy advisor for the American Heart Association. He is a an internationally recognized expert in stroke diagnosis, treatment and prevention and a Fellow of the American Heart Association, American Academy of Neurology and the American Neurological Association. His research has been funded by many organizations including the NIH, AHA, PCORI, AHRQ, HRSA, CDC, and others, and he is the author of >500 peer-reviewed articles and chaired many of the current practice guidelines for stroke and telehealth-enabled care delivery. Under his leadership, the AHA Get with the Guidelines–Stroke Registry has grown into the world’s largest stroke registry with over 8M patient encounters; it has changed stroke practice at hospitals across the US, and set a global standard for stroke care. He has received numerous awards for innovation, leadership, and advocacy in the field of stroke and digital health, and held many senior leadership positions within the AHA, including service on their National Board of Directors. He has served on multiple editorial boards, including the digital health section editor for Stroke, and the international advisory board for Lancet Digital Health.
Appointments
Office of the Dean, School of Medicine
Associate DeanDualBiomedical Informatics & Data Science
ProfessorSecondaryNeurology
ProfessorSecondary
Other Departments & Organizations
- Biomedical Informatics & Data Science
- Digital Technology Solutions Leadership
- Neurology
- Office of the Dean, School of Medicine
- Virtual Care Consensus
- Yale Medicine
Education & Training
- Fellowship
- Massachusetts General Hospital (1996)
- Residency
- Massachusetts General Hospital (1995)
- Internship
- Beth Israel Hospital (1992)
- MD
- Harvard Medical School, Medicine (1991)
- AB
- Harvard University, Philosophy (1985)
Research
Publications
2024
Reviewer Experience Detecting and Judging Human Versus Artificial Intelligence Content: The Stroke Journal Essay Contest.
Silva G, Khera R, Schwamm L, Acampa M, Adelman E, Boltze J, Broderick J, Brodtmann A, Christensen H, Dalli L, Duncan K, Elgendy I, Ergul A, Goldstein L, Hinkle J, Johansen M, Jood K, Kasner S, Levine S, Li Z, Lip G, Marsh E, Muir K, Ospel J, Pera J, Quinn T, Räty S, Ranta A, Richards L, Romero J, Willey J, Hillis A, Veerbeek J. Reviewer Experience Detecting and Judging Human Versus Artificial Intelligence Content: The Stroke Journal Essay Contest. Stroke 2024, 55: 2573-2578. PMID: 39224979, DOI: 10.1161/strokeaha.124.045012.Peer-Reviewed Original ResearchConceptsArtificial intelligenceEditorial board membersAuthor typeTraditional peer reviewLanguage modelIntelligent contentAuthor attributionGeneral textAI expertiseHuman authorityImproved accuracyAuthor's identityAuthor's manuscriptScientific journalsEssay contestPeer reviewPerception of qualityAuthorshipNature of authorshipIntelligenceLLMScientific writingScientific essayEssay qualityEssayFactors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic
Wilcock A, Zubizarreta J, Wadhera R, Yeh R, Zachrison K, Schwamm L, Mehrotra A. Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic. JAMA Cardiology 2024, 9 PMID: 39083317, PMCID: PMC11292572, DOI: 10.1001/jamacardio.2024.2031.Peer-Reviewed Original ResearchHospital encountersAcute myocardial infarctionCare avoidanceShort-term acute careAcute myocardial infarction incidenceAcute myocardial infarction ratesTemporal trendsCOVID-19 pandemicPatient characteristicsTraditional Medicare claimsCross-sectional studyPandemic-related changesAMI incidenceCOVID-19 death ratesAcute careMyocardial infarctionMedicare claimsMain OutcomesExcess deathsExcess mortalityStudy samplePrepandemic levelsTraditional MedicareUnited StatesCOVID-19Contemporary Prestroke Dual Antiplatelet Use and Symptomatic Intracerebral Hemorrhage Risk After Thrombolysis
Peng T, Schwamm L, Fonarow G, Hassan A, Hill M, Messé S, Coronado F, Falcone G, Sharma R. Contemporary Prestroke Dual Antiplatelet Use and Symptomatic Intracerebral Hemorrhage Risk After Thrombolysis. JAMA Neurology 2024, 81: 722-731. PMID: 38767894, PMCID: PMC11106713, DOI: 10.1001/jamaneurol.2024.1312.Peer-Reviewed Original ResearchRisk of symptomatic intracerebral hemorrhageSymptomatic intracerebral hemorrhageTreated with IV-tPAAcute ischemic strokeIV-tPAAmerican Heart Association and American Stroke AssociationAssociated with lower oddsIschemic strokeDual antiplatelet therapyAssociated with increased riskPropensity score subclassificationAmerican Stroke AssociationIntracerebral hemorrhage riskGWTG-StrokeSymptomatic intracerebral hemorrhage riskGuidelines-StrokeDischarge modified Rankin Scale scoreIn-hospital deathStroke AssociationLower oddsRate of symptomatic intracerebral hemorrhageAntiplatelet therapyCohort studyAssociated with symptomatic intracerebral hemorrhagePrestrokeTenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial
Xiong Y, Wang L, Pan Y, Wang M, Schwamm L, Duan C, Campbell B, Li S, Hao M, Wu N, Cao Z, Wu S, Li Z, Wang Y. Tenecteplase versus alteplase for acute ischaemic stroke in the elderly patients: a post hoc analysis of the TRACE-2 trial. Stroke And Vascular Neurology 2024, svn-2023-003048. PMID: 38858097, DOI: 10.1136/svn-2023-003048.Peer-Reviewed Original ResearchSymptomatic intracranial haemorrhageAcute ischaemic strokeModified Rankin ScaleElderly patientsPost hoc analysisAlteplase groupTenecteplase groupHoc analysisAlternative to alteplaseModified Rankin scale 0Ischaemic strokeRisk-benefit profileNon-inferiority clinical trialBenefit-risk profileEfficacy outcomesProportion of participantsReperfusion therapyIntracranial haemorrhageClinical trialsRankin ScaleSymptom onsetTenecteplaseAlteplaseIntravenous thrombolyticsSafety outcomesMapping the Ecological Terrain of Stroke Prehospital Delay: A Nationwide Registry Study
Dhand A, Reeves M, Mu Y, Rosner B, Rothfeld-Wehrwein Z, Nieves A, Dhongade V, Jarman M, Bergmark R, Semco R, Ader J, Marshall B, Goedel W, Fonarow G, Smith E, Saver J, Schwamm L, Sheth K. Mapping the Ecological Terrain of Stroke Prehospital Delay: A Nationwide Registry Study. Stroke 2024, 55: 1507-1516. PMID: 38787926, PMCID: PMC11299104, DOI: 10.1161/strokeaha.123.045521.Peer-Reviewed Original ResearchConceptsSocial Vulnerability IndexPrehospital delayHospital arrivalZIP Code Tabulation AreasEmergency medical servicesCommunity-level social vulnerabilityGuidelines-Stroke registryCommunity socioeconomic statusCommunity-level factorsPatient-level factorsNationwide registry studyAmerican Heart AssociationSocial vulnerabilityCox proportional hazards modelsSocially vulnerable areasAssociated with delaySocial determinantsProportional hazards modelAcute stroke treatmentGeospatial mappingSocioeconomic statusMedical servicesIncreased social vulnerabilityPrimary exposureQuartile 3Cost-effectiveness of atrial fibrillation detection with insertable cardiac monitors in large-artery or small-vessel disease stroke in the United Kingdom
Witte K, Schwamm L, Bernstein R, Reynolds M, Rose D, Lip G, Ozturk E, Villinger J, Rosemas S, Ziegler P, Yaghi S. Cost-effectiveness of atrial fibrillation detection with insertable cardiac monitors in large-artery or small-vessel disease stroke in the United Kingdom. EP Europace 2024, 26: euae102.603. PMCID: PMC11120381, DOI: 10.1093/europace/euae102.603.Peer-Reviewed Original ResearchQuality-adjusted life yearsInsertable cardiac monitorCHA2DS2-VASc scoreContinuous cardiac monitoringStroke eventsAtrial fibrillationCardiac monitoringNational Health Service (NHSBase case incremental cost-effectiveness ratioCHA2DS2-VAScInsertable cardiac monitor implantationDetection of AFHealth-related benefitsRisk of AFUnited KingdomCost-effectiveLarge-arteryRisk of cerebrovascular eventsIschemic strokeWillingness-to-pay thresholdsDetect atrial fibrillationIncremental cost-effectiveness ratioCost-effectiveness analysisProbabilistic sensitivity analysesSmall vessel disease strokeStrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records
Lee H, Schwamm L, Sansing L, Kamel H, de Havenon A, Turner A, Sheth K, Krishnaswamy S, Brandt C, Zhao H, Krumholz H, Sharma R. StrokeClassifier: ischemic stroke etiology classification by ensemble consensus modeling using electronic health records. Npj Digital Medicine 2024, 7: 130. PMID: 38760474, PMCID: PMC11101464, DOI: 10.1038/s41746-024-01120-w.Peer-Reviewed Original ResearchElectronic health recordsWeighted F1MIMIC-IIIClinical decision support systemsMulti-class classificationNatural language processingMIMIC-III datasetHealth recordsMachine learning classifiersDecision support systemArtificial intelligence toolsVascular neurologistsLearning classifiersBinary classificationCross-validation accuracyLanguage processingMeta-modelIntelligence toolsStroke prevention effortsAcute ischemic strokeStroke etiologySupport systemStroke etiology classificationClassification toolClassifierTwenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges
Reeves M, Fonarow G, Smith E, Sheth K, Messe S, Schwamm L. Twenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges. Stroke 2024, 55: 1689-1698. PMID: 38738376, PMCID: PMC11208062, DOI: 10.1161/strokeaha.124.046527.Peer-Reviewed Original ResearchMP-470553-002 ECONOMIC EVALUATION OF INSERTABLE CARDIAC MONITORS COMPARED TO SHORT-TERM MONITORING TO DETECT ATRIAL FIBRILLATION AFTER STROKE ATTRIBUTED TO LARGE-ARTERY OR SMALL-VESSEL DISEASE
Reynolds M, Pollit V, Schwamm L, Rose D, Witte K, Yahgi S, Cudworth S, Carpenter J, Rosemas S, Ziegler P, Neisen K, Franco N, Margetta J, Pouliot E, Bernstein R. MP-470553-002 ECONOMIC EVALUATION OF INSERTABLE CARDIAC MONITORS COMPARED TO SHORT-TERM MONITORING TO DETECT ATRIAL FIBRILLATION AFTER STROKE ATTRIBUTED TO LARGE-ARTERY OR SMALL-VESSEL DISEASE. Heart Rhythm 2024, 21: s117. DOI: 10.1016/j.hrthm.2024.03.486.Peer-Reviewed Original ResearchTrends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021.
Skajaa N, Laugesen K, Lauffenburger J, Schwamm L, Sørensen H, Patorno E. Trends in the Use of Medications for Secondary Ischemic Stroke Prevention in Denmark, 2005-2021. Neurology 2024, 102: e209309. PMID: 38648572, PMCID: PMC11226314, DOI: 10.1212/wnl.0000000000209309.Peer-Reviewed Original ResearchConceptsMedication useOral anticoagulant medicationsGlucose-lowering medication useFactors associated with medication useLipid-lowering medication useSevere strokeIschemic stroke hospitalizationsAntihypertensive medication useAnticoagulant medicationOlder patientsCare of patientsSodium-glucose cotransporter-2 inhibitorsGlucagon-like peptide-1 receptor agonistsStroke preventionAnticoagulant medication useLipid-loweringPeptide-1 receptor agonistsGlucose-loweringReduced life expectancyIschemic strokeCotransporter-2 inhibitorsStroke careCohort of patientsStroke hospitalizationsSecondary ischemic stroke prevention
Clinical Care
Overview
Lee H. Schwamm, MD, is an internationally recognized expert in the prevention, diagnosis, and treatment of stroke and transient ischemic attack (TIA). His research and clinical interests focus on stroke in the young and those whose strokes are without apparent cause (called cryptogenic strokes). He has been a leader in stroke clinical research, and has participated in the design or conduct of major trials that have defined how stroke is currently measured and treated, and how the guideline-recommended treatments are actually administered when patients are hospitalized for stroke. He deeply enjoys mentoring emerging leaders in academic medicine, and his work has been recognized by major grants and awards, including several of the highest volunteer awards from the American Heart Association.
In addition to his expertise in stroke, Dr. Schwamm is a leader in digital health and digital transformation. He realized early on that his work as a neurologist could be augmented with the infusion of big data, technology, and focusing on improving the processes of how health care is delivered. This translates to redesigning care delivery through the human-centered lens of the experiences of patients and providers, and letting the clinical problem drive what technology can be used to make things better (and not the other way around). “We have a real opportunity now to start capturing a lot more information about our patients in the parts of their life beyond the clinic and the hospital, such as with monitors, sensors, and smartphones, to regularly collect weight, activity, or blood pressure and transmit those results to the electronic medical record,” Dr. Schwamm says. By doing so, doctors can build a smarter profile of their patients, tailor treatments to them as individuals, and get their risk factors under control faster and more safely.
“I’ve always been drawn to the brain,” says Dr. Schwamm. “This fascination began when I chose to major in philosophy in college, and it drove me to choose neurology as my specialty. Within neurology, I gravitated to stroke because of the new treatments that had just emerged that could halt or reverse the damage being caused to the brain. I was able to make a major contribution by developing the ability to leverage technology to increase access to stroke specialists and improve outcomes for all stroke patients, not just those lucky enough to live near a major stroke center.”
Dr. Schwamm also serves as senior vice president and chief digital health officer for Yale New Haven Health (YNHH) and as a professor in Biomedical Informatics & Data Sciences at Yale School of Medicine (YSM). As the associate dean for digital strategy and transformation, he is leading the development of a new digital health strategy for YSM and YNHH. Dr. Schwamm has done extensive research and is especially interested in patterns of care delivery for stroke in the United States; how patients move from one health system to another during emergencies, before or after their stroke; and opportunities to identify and eliminate inequities in care.
“I often say, my car gets better health care than I do. Most patients show up in my office when they have the equivalent of a flat tire, or have run out of gas, or have an engine that is overheated, metaphorically speaking,” he says, “Our job as health care providers is to intervene before those critical events happen.”
All my goals really boil down to removing the barriers between patients and the care they need, Dr. Schwamm adds. “One way is to build high-reliability systems wherever we can so that we don't rely on people doing the right thing every time with good intention, but rather, we have systems that support us in doing that right thing every time.”