With HLTH, ViVE, and HIMSS, the industry seems to have settled on a schedule for fostering new ideas and technologies
As the busy exhibit hall at this year’s HIMSS24 conference in Orlando can attest, healthcare’s biggest technology event is back. But that success is tied to a change in how the industry’s decision-makers view HIMSS and its main competitors, ViVE and HLTH.
Simply put, HIMSS is becoming the place to talk collaboration and make technology deals that power a lot of the industry’s innovation efforts. But unless they’re appearing in a session or accepting an award, the C-Suite is staying away and delegating that authority to others—namely, executives who are actually using the technology.
“We need to understand what clinicians really want,” said David Sides, president and CEO of NextGen Healthcare. “And the value is in the details.”
And the ROI has to be immediate.
“Everyone is focused on doing more with less,” added Brendan Watkins, chief analytics officer at Stanford Children’s Health. “So when you look at something, you look at how it delivers the right insights to improve decision-making.”
At HLTH and especially ViVE, the C-Suite was notably present. And CIOs, CEOs, CTOs, CNOs and CFOs weren’t coming for the free food, drinks, and entertainment (though that may have helped). They were making the trip to get together with their peers and discuss strategy, and to see some of the newer ideas and technologies that aim to push healthcare out of its doldrums and advance value-based care.
HIMSS CEO Hal Wolf said as much during his press get-together as HIMSS24 opened this year. He’s not looking to attract the top-level executives, but targeting those within the health systems and hospitals who benefit the most from the technology. They’re the ones who can really define the ROI for a new platform or tool and tell their bosses whether it’s working or just costing valuable time and money.
That deals were being made at HIMSS this year is proof that the industry is focused on using technology to address its biggest pain points. AI and security were the top topics, and while health systems and hospital leaders were looking for solutions and partners to address those needs, vendors were talking to each other as well about collaborations that would create enterprise-wide, multi-point products instead of niche solutions.
“There’s quality, and then there’s paper cuts,” said David Linz, MD, chief medical informatics officer at Florida’s NCH Healthcare. “You want something that makes a difference.”
And many of these conversations were fueled by discussions that had started at HLTH and carried over to ViVE (or were even begun at CES). At those events, executives bounced ideas off each other and talked about how the industry as a whole could embrace the technology it needs. The panels and discussions were more high-level, reflecting an industry intent on collaboration.
With that in mind, the healthcare industry seems to be settling into a rhythm that will define the innovation landscape. The ideas and debates will percolate up through HLTH and ViVE, then find footing at HIMSS through deals and collaborations.
The Match IT Act of 2024, now before Congress, would create a federal definition for 'patient match rate' that providers would address as they would a clinical quality measurement
A new bill before Congress aims to jump-start the unique patient identifier conversation by creating a healthcare industry standard definition for “patient match rate” and improving provider efforts to match patients with their health records.
The Patient Matching and Transparency in Certified Health IT (Match IT) Act of 2024, introduced in February by US Reps. Mike Kelly (R-PA) and Bill Foster (D-IL), would, if passed into law, set the bar for providers in matching patients to their records. It would establish the patient match rate as a clinical quality measurement, creating standards by which providers identify patients with their services and information.
The legislation addresses a key pain point in the interoperability arena, where supporters have long argued for the establishment of a unique patient identifier (UPI), or individual code similar to a social security number that would be used by providers to identify and match patient data. While that debate has bogged down (with some critics blaming the heated political environment), this bill would move away from that issue and give health systems something to work with.
“We have this major issue in the industry that’s costing lives, costing money, costing time [and] causing a lot of frustration,” says Aaron Miri, MBA, FCHIME, CHCIO, senior vice president and chief information and digital health officer at Baptist Health Jacksonville. “This gives us [an opportunity] to create a measurement of success, a benchmark.”
Clay Ritchey, CEO of digital identity management company Verato, said the bill comes as the industry is making a “mad dash” toward digital transformation and interoperability. Healthcare executives are struggling, he says, to manage and use vast amounts of data, including unstructured data coming in from outside the EHR, and trying to avoid data silos as they move toward value-based care.
“We often don’t know who’s who across each of these touch points,” he says. “That’s why we need meaningful standards in place.”
In a press release introducing the bill, Kelly said 35% percent of all denied claims result from inaccurate patient identification, costing the average hospital $2.5 million and the industry more than $6.7 billion annually. In addition, the cost of repeated or unnecessary care due to inaccurate medical data costs $1,950 per patient inpatient stay and more than $1,700 per ED visit.
And that’s not counting the patients who suffer harm from an unnecessary medial procedure (such as surgery on the wrong site or incorrectly prescribed medications).
"This legislation would promote interoperability of patient matching systems, which would protect patients and decrease burdens on healthcare providers,” added Foster.
The bill has drawn support from a number of healthcare organizations, including HIMSS, CHIME, and AHIMA, all part of the Patient ID NOW coalition. Another member of that coalition is Intermountain Health, whose chief digital and information officer, Craig Richardville, MBA, CHCIO, also backs the bill.
“[T]his legislation will address our nation’s current inability to consistently and accurately identify patients to their health records. Improved standardization of patient demographic data will lead to more accurate patient matching, which in turn will produce advances in patient safety, more complete information for clinical care, and cost savings from reducing the need for repeated medical care, among other benefits,” Richardville said in a Patient ID NOW press release on the legislation.
Aside from reducing patient harm and unnecessary medical expenses, Miri said the bill would gives hospital and health system executives an important tool in managing patient data—including that of their own doctors and nurses. And with Baptist Health Jacksonville managing some 35 million unique patients now and seeing roughly 100 people a day moving into northern Florida, the health system needs to keep track of who it’s treating and hire more clinicians to handle the growth.
It would also fit well with the industry’s emphasis on patient-centered care and patient engagement initiatives.
“We have a consumer demand that’s insatiable for their own data,” he points out.
So while the UPI argument seems stalled, advocates for the Match IT Act of 2024 are hoping that bipartisan support will propel the bill at a time when Congress is struggling to agree on anything.
The health system is working with a Norwegian digital health company to develop an app that would allow parents to test their babies at home
Intermountain Health is developing a digital health app for smartphones that will help parents identify jaundice in their babies at home.
The Salt Lake City-based health system is partnering with Norwegian digital health company Picterus AS to create the app, which would use a smartphone camera and a laminated card to measure bilirubin levels in newborns without the need for a return trip to the hospital or clinic and a blood draw.
“Bilirubin and jaundice management has long been based in the hospital and the clinic,” Tim Bahr, MD, an neonatologist who is leading the study, said in a press release. “Taking a newborn to the clinic or laboratory for frequent blood tests in the first days of life can be a huge inconvenience and burden on families. We hope to simplify this care and move more of it into the home. This is a win for families and for our healthcare system.”
The app addresses a care management pain point for hospitals. According to the March of Dimes, three of every five babies born in the US develop jaundice within days after birth. Many recover quickly with little medical intervention, but jaundice can lead to serious health concerns, including Hyperbilirubinemia, brain damage, or hearing loss, if untreated.
Intermountain, which greets and tests 33,000 newborns a year, aims to turn the smartphone into a diagnostic tool that would enable parents to quickly check their baby’s health at home after discharge from the hospital, and to contact their care providers if jaundice is evident. Parents would use their phone to snap roughly six photos of the laminated calibration card placed on the chest of their baby, and the app would translate those photos into a diagnosis.
“We do know that parents are pretty good at taking pictures of their babies,” Bahr noted in the press release.
“This technology is exciting to us because it makes it possible to measure the bilirubin in a baby without taking blood,” he added. “Right now, the only way to measure bilirubin levels in babies is to take them to a laboratory and draw blood. By having this technology available on a smartphone, we will eventually empower parents to make these measurements without having to leave their homes with an easily accessible and affordable tool.”
The health system is testing the digital health tool on about 300 term babies born at Intermountain Utah Valley Hospital in Provo, Intermountain McKay-Dee Hospital in Ogden, and Intermountain Medical Center in Murray, as well as on about 100 pre-term babies. They’ll test the app against the traditional method of drawing blood.
If proven reliable and introduced to clinical care, the app could not only save new parents the hassle of return trips and treatment, but help providers identify and treat jaundice earlier and more effectively, improving clinical outcomes and reducing costs.
As the industry assesses the financial damage of the cyberattack, healthcare execs will also be looking at how their technology strategies can be improved
The workaround is a popular healthcare technology term right now.
As healthcare organizations across the country assess the damage caused by the Change Healthcare outage, executives are not only looking at the financial fallout but also the technological repercussions. In short, what will health systems need to do to make sure this doesn’t happen again—or if it does happen, that they have the resources in place to minimize damage?
According to the results of an American Hospital Association survey of roughly 1,000 hospitals released on Friday, some 81% of hospitals found that workarounds enacted to keep operations going during the outage were only “somewhat successful,” while 11% found that workarounds didn’t work at all. And two-thirds of those responding to the survey said it difficult or very difficult to deploy workarounds, particularly in switching clearinghouses.
As has been well-reported, the financial implications are even more alarming. According to the survey, 94% reported being affected financially, with more than half sustaining “significant or serious” damage. About one-third reported impacted to at least half of their revenue and about 60% saw that impact to be more than $1 million a day. Some 44% expect the negatives to continue for another two to four months, and more than 20% have no idea when the tide will turn.
The takeaway is that healthcare executives will need to think long and hard about what they need to do to improve their technology infrastructure, on both the financial and clinical sides.
“These survey findings are another irrefutable reminder that the impact of this cyberattack is far reaching and far from over,” AHA President and CEO Rick Pollack said in a press release accompanying the survey. “When nearly every hospital says they are experiencing a financial loss and half of those say it’s ‘significant or serious,’ with no immediate end in sight, then the debate about whether we need to help them should be over.”
The AHA is one of several organizations calling on federal authorities to take action, and an investigation has reportedly been launched to see whether UnitedHealth Group did anything wrong that led to the attack or caused it to be so damaging.
“We continue to call on Congress and the Administration to take additional actions now to support providers as they deal with significant fallout from this historic attack,” Pollack said. “We also need UnitedHealth Group and commercial payers to step up and support patients and providers on the front lines by waiving prior authorization and timely filing requirements, as well as advancing payments that will allow providers to continue providing 24/7 care to communities.”
Beyond that, healthcare organizations need to take stock of how an incident like this affects clinical care. According to the AHA survey, almost three of every four hospitals reported a negative effect to patient care, and nearly 40% said patients had difficulties accessing care, most often because of disruptions to the health plan authorization process.
AI adoption is fast outpacing governance, and with memories (or nightmares) of EMR adoption and the Change Healthcare outage on everyone’s mind, the pressure is on to set up guardrails
With HIMSS24 in the rear-view mirror, one of the biggest takeaways from the conference was the energy and attendance. Healthcare’s movers and shakers were here, at least for a day or two, and they were making deals and forging partnerships.
And while AI tools and programs were dominating the discussion and deals, a lot of talk was centered on Ai accountability.
While the year-old Coalition for Health AI (CHAI) made early news with its announcement of advisory boards and partnerships, Microsoft unveiled its own Trustworthy & Responsible AI Network (TRAIN), an intriguing collaboration of health systems and federal representatives that aims to create more structure in the move toward governance.
“When it comes to AI’s tremendous capabilities, there is no doubt the technology has the potential to transform healthcare. However, the processes for implementing the technology responsibly are just as vital,” David Rhew, MD, Microsoft’s global chief medical officer and vice president of healthcare, said in a press release. “By working together, TRAIN members aim to establish best practices for operationalizing responsible AI, helping improve patient outcomes and safety while fostering trust in healthcare AI.”
Rhew also commented on LinkedIn on how CHAI and TRAIN will co-exist.
“One way to look at it is that CHAI focuses on ‘the what,’” he wrote. “What is responsible AI (RAI)? What are the RAI principles and standards? ... while TRAIN focuses on ‘the how.’ How does one operationalize RAI? How can organizations collaborate in a privacy-preserving manner, such that data and IP are not exposed? How can we ensure that low-resource settings are able to apply RAI?
Simply put, CHAI helps develop the RAI standards, while TRAIN helps organizations implement them, through the use of technology-based RAI tools and guardrails.”
That post hints at the understanding that while everyone agrees the industry needs guardrails, how we get there will be a challenge. And with all the announcements and talk at HIMSS24 of health systems and hospitals launching AI programs, the urgency to create standards is growing by the day.
Many also don’t want the process to mirror EMR adoption two decades ago. The healthcare industry wasn’t prepared to embrace electronic medical records, leading to more than a few nightmares in implementation and the need for meaningful use guidelines. Now AI adoption is fast outpacing governance, and executives are in some ways nostalgic for the guidance offered by meaningful use.
Add to that the concern around the recent Change Healthcare cybersecurity attack some three weeks ago. The outage filtered into many a conversation at HIMSS24, creating a stir around the section of the exhibit hall given over to cybersecurity companies. While the incident has been tied back to a ransomware gang, more than a few people have wondered whether unchecked use of AI could lead to more data breaches – or whether AI could be used as a tool against attacks.
For example, Nordic Consulting announced at HIMSS24 a partnership with Microsoft Azure and Amazon Web Services to launch a Cloud Innovation Lab, addressing requests from healthcare organizations for help in expanding and managing their data storage capabilities, in part because of the increase in AI programs. Brijeet Akula, a Principal Architect at Nordic Consulting, said company was seeing a lot of business from hospitals and health systems spooked by the outage.
“They have sped up their desire to explore more security methods,” he noted.
So while security may be an outlier, it will add to the urgency to create guardrails around AI. The Biden Administration has set its course with an October 2023 Executive Order on AI and announcements of actions to come, but CHAI and TRAIN offer proof that there will be more players in the game.
Like CHAI, TRAIN has an impressive (and in some cases overlapping) roster. Along with healthcare technology company TrueBridge, participating health systems include AdventHealth, Advocate Health, Boston Children’s Hospital, Cleveland Clinic, Duke Health, Johns Hopkins Medicine, Mass General Brigham, MedStar Health, Mercy, Mount Sinai Health System, Northwestern Medicine, Providence, Sharp HealthCare, University of Texas Southwestern Medical Center, University of Wisconsin School of Medicine and Public Health and Vanderbilt University Medical Center, and the organization will be working with OCHIN, a non-profit innovation center with strong ties to Epic.
So even as these organizations are deploying AI in several, if not hundreds, of use cases, the talk in the background is around setting up accountability as soon as possible—especially before those use cases start involving patients.
“Even the best healthcare today still suffers from many challenges that AI-driven solutions can substantially improve,” Peter J. Embí, MD, MS, a professor and chair of the Department of Biomedical Informatics (DBMI) and senior vice president for research and innovation at Vanderbilt University Medical Center, said in the press release.”However, just as we wouldn’t think of treating patients with a new drug or device without ensuring and monitoring their efficacy and safety, we must test and monitor AI-derived models and algorithms before and after they are deployed across diverse healthcare settings and populations, to help minimize and prevent unintended harms. It is imperative that we work together and share tools and capabilities that enable systematic AI evaluation, surveillance and algorithm vigilance for the safe, effective and equitable use of AI in healthcare.”
A HIMSS24 panel discusses how competition and uncertain reimbursements are forcing providers to change their business model
Healthcare providers are starting to rethink what being a provider actually means.
Stung by high costs and low reimbursements for acute care, some health systems are shifting their sights to care management and preventive care. And they’re making patient engagement a priority.
“A great deal of our future is in the outpatient side,” Tressa Springman, SVP and chief information and digital officer at LifeBridge Health, a five-hospital system based in Maryland, said during a panel session Tuesday at HIMSS 24.
She noted that more than 50% of the health system’s quality-based reimbursement score for the state is focused on the patient experience, making that more important than actual clinical care. So they’re now setting their sights on access, convenience, and outpatient interactions.
“We’re really focusing on the community,” she said.
Indeed, smaller health systems and hospitals are being forced to change their priorities just to stay in business. Rural hospitals are shutting down or shifting to emergency care centers. Others are closing their Eds and ICUs, referring patients to stand-alone urgent care centers, and looking more closely at a concierge care strategy.
The HIMSS24 panel, titled “Moving Beyond EHR Engagement: Deploy Consumer-Centric Strategies That Truly Empower Communities,” took a closer look at how providers are making engagement work. They’re listening more to their patients, embracing remote patient monitoring, virtual care, wearables and home-based services, and targeting care management and coordination.
“We want to know more about our patients,” said Eric Alper, MD, vice president, chief quality officer and chief clinical informatics officer at UMass Memorial Health. “The Joint Commission and CMS are actually [demanding] it.”
This strategy isn’t without its challenges. As the title of the session implies, a lot of the information providers need isn’t found in the EHR, and so health systems and hospitals are investing in bolt-on technologies and programs, weaving care in and out of the medical record. They’re paying more attention to social determinants of health (SDOH), and fashioning programs that revolve around the patient’s preferences and needs.
Michael Garcia, vice president and chief information officer at the Miami-based Jackson Health System, noted that his health system is making more of an effort to tailor healthcare to patients who typically have trouble accessing care. At Jackson Health, that includes significant numbers of homeless people, undocumented immigrants, and people who are either incarcerated or recently released from prison.
That strategy is based on necessity. If the health system doesn’t reach out and provide care when and where they need it, he said, those patients will end up in Jackson Health’s already-overcrowded Emergency Department.
All three panelists and their moderator, GetWellNetwork founder and CEO Michael O’Neil, noted that this type of strategy doesn’t have a gameplan or model to work from, and no one has come up with any best practices yet. Providers are on their own in developing these care pathways, and in many cases each is developing a unique strategy.
Then again, today’s consumers aren’t looking for a cookie-cutter approach to engagement.
“The ordinary person doesn’t care how much scale you have in your organization,” O’Neil pointed out.
Springman noted that disruptors are making the primary care space very competitive, and it’s difficult for providers to match what Amazon, Walmart, and others are offering. Somewhat ironically, that’s forcing providers to re-engage with their patients, establishing new relationships that technology has for the past few years interrupted.
“We actually are investing much more in well care than in sick care,” she said.
As the annual conference and exhibition opens this week in Orlando, healthcare executives are looking anxious for some good news, or at least positive ROI
The healthcare industry is in a rough spot right now, buffeted by cybersecurity issues, disruptors with big dreams, workforce declines, labor unrest, mangled mergers and closures. As the annual HIMSS conference convenes in Orlando this week, a lot of people are looking for some good news. We’re at that point in Marcus Welby, MD, or Emergency or St. Elsewhere or ER or Grey’s Anatomy or House or Chicago whatever that the patient is on life support and everyone’s just sitting around waiting for inspiration to strike,
Might AI be that shining moment? Could VR save the day? How about FHIR? Perhaps.
As the camera pans out and HIMSS24 steps into focus, here are a few thoughts on what we’ll be seeing and talking about this week in the land of Disney.
AI comes of age. As this week’s flurry of announcements can attest, healthcare organizations are turning AI loose on some of the industry’s most vexing pain points. The HIMSS agenda is filled with sessions detailing how health systems are using the technology, and a casual walk around the exhibit hall will unveil plenty of vendors armed with use cases and examples of ROI.
Indeed, many of the press releases coming out this week are focusing on new partnerships or capabilities around AI. Providers are collaborating with their EHR providers and digital health companies to move data through the platform more efficiently, giving doctors and nurses what they need at the point of care to improve their work and, ultimately, their work-life balance.
The most popular use case at present is the development of ambient AI tools to capture conversations and convert them to clinical notes. Healthcare executives are eager to see how the technology can take documentation and data entry out of the clinician’s hands, which not only gives the doctor or nurse more time to spend in front of patients but reduces the tasks that cause stress and eat into home and family time. But this isn’t the only example of how the technology is being used, and savvy decision-makers will be looking beyond the obvious to find other use cases that help struggling hospitals improve workflows and reduce cost.
A looming battle over value? While AI use cases are all the rage, there’s plenty of talk about how the technology will be governed. The Coalition for Health AI (CHAI) made news recently with the announcement of several advisory boards and a couple of collaborations aimed at creating guidelines for the ethical use of AI, but that news caused more than a few critics to wonder how a struggling health system might weigh the financial value of an AI tool against its potential to boost clinical outcomes.
The argument isn’t new to healthcare, especially as the industry tries to wrap its arms around value-based care. But the speed at which AI has moved into the healthcare ecosystem is putting pressure on health systems to take a closer look at what the “ethical use of AI’ really means. Can the industry find a common ground on which to measure value? Will recent stories around the use of AI by payers to sort and deny claims be enough of a warning sign to spur meaningful conversation? And will the industry work with the federal government to set the guardrails?
The Change Healthcare ransomware attack is having an impact. As expected, the ongoing cybersecurity attack on UnitedHealth Group’s IT platform is affecting both attendance and conversations. Some health system executives are shortening or cancelling their plans to be in Orlando to deal with the outage, while cybersecurity vendors are using the outage as a conversation starter.
The outage has elevated the “workaround” to a common topic of conversation, as beleaguered healthcare providers look for alternate strategies to keep the doors open in the wake of delayed payments. It has also forced many executives to take a closer look not only at their internal and vendor security protocols, but their cash-on-hand strategies. In fact, healthcare organizations seem more focused on how they can weather the next big cybersecurity incident than on how to prevent it.
This will be a huge topic of conversation at HIMSS. Cybersecurity incidents are occurring with such frequency in healthcare now that organizations are putting more thought into limiting the damage when something happens. And as the Change Healthcare outage proves, healthcare organizations have to plan not only for something that happens to them, but also for something that can affect a large swathe of the industry.
Setting a solid foundation. Finally, one of the bigger takeaways from ViVE was that healthcare organizations were paying more attention to how they gather, store, and manage data. That hasn’t changed in Orlando, and HIMSS’ longtime focus on interoperability will keep that conversation going. Innovation in healthcare these days is less about the new toys and more about how data is used to improve things inside and outside the hospital, clinic, or doctor’s office. From smart hospital rooms of the future that gather and funnel information wirelessly, to remote patient monitoring and hospital at home programs that create a data highway from care team to patient, to SDOH programs that mine data for healthcare challenges and barriers and create programs around addressing those challenges, the connecting concept is connectivity.
While strategies like TEFCA and FHIR aim to create a nationwide interoperability platform, providers are just as interested now in strategies and technology that can handle the data they have or want to have. They want tools to pull it in from outside the enterprise, sort it quickly and efficiently without the need for manual labor, and get it to the right people at the right place at the right time, regardless of EHR platform or HIT framework. They’re looking at more data than they’ve ever had before, and the volume or value certainly won’t decrease.
This week’s conference is more about making those connections that work, finding value in partnerships and technology that make things run easier at a time when healthcare is desperate for efficiency. So any use case this week with solid ROI will be trumpeted, as will any collaboration that “pushes the needle” on improved outcomes.
Healthcare needs some good news before the final credits roll.
The tool is designed to help clinicians identify a common type of ear infection that's often overlooked or misdiagnosed
Clinicians at UPMC and the University of Pittsburgh have developed an AI algorithm that can identify acute otitis media (AOM), one of the most common childhood infections.
While some 70% of children have an ear infection before their first birthday, those infections are hard to spot and are often misdiagnosed as fluid buildup. To identify AOM, clinicians need to peer into the eardrum and identify subtle signs of an infection, often a difficult task when dealing with an infant or small child.
To help clinicians make a better diagnosis, researchers created an AI tool that can analyze a video of a patient’s eardrum, taken by an otoscope connected to a camera.
“Acute otitis media is often incorrectly diagnosed,” Alejandro Hoberman, MD, a professor of pediatrics and director of the Division of General Academic Pediatrics at Pitt’s School of Medicine and president of UPMC Children’s Community Pediatrics, said in a press release. “Underdiagnosis results in inadequate care and overdiagnosis results in unnecessary antibiotic treatment, which can compromise the effectiveness of currently available antibiotics. Our tool helps get the correct diagnosis and guide the right treatment.”
“The eardrum, or tympanic membrane, is a thin, flat piece of tissue that stretches across the ear canal,” he added. “In AOM, the eardrum bulges like a bagel, leaving a central area of depression that resembles a bagel hole. In contrast, in children with otitis media with effusion, no bulging of the tympanic membrane is present.”
Hoberman and his team created the tool by studying more than 1,100 videos of the tympanic membrane in children who had visited a doctor for treatment between 20-18 and 2023. They used the videos to develop two AI models that can detect AOM by studying the features of the tympanic membrane, including shape, position, color, and transparency.
According to Hoberman, the AI tool has a 93% success rate in identifying AOM. That’s better than various studies that have put the success rate of physicians studying a patient’s ear at between 30% and 84%.
“These findings suggest that our tool is more accurate than many clinicians,” he said in the press release. “It could be a gamechanger in primary healthcare settings to support clinicians in stringently diagnosing AOM and guiding treatment decisions.”
Healthcare organizations across the country are developing hundreds of AI tools to aid clinicians, drawing on technology that can often analyze data more efficiently than the human eye. These tools can also store the data in the EHR, enabling clinicians to review their work, show the results to parents, and use the data for training.
Three large health systems have announced plans to put AI to use to address clinical care gaps
Now that they’re seeing AI in action, health systems are putting the technology to use to address clinical care gaps.
WellSpan Health, UMass Memorial Health, and Intermountain Health have all announced new collaborations aimed at using AI in clinical settings. WellSpan Health will be developing ambient AI tools to capture doctor-patient conversations, a compelling use case that was discussed at the recent ViVE conference, while UMass Memorial and Intermountain are targeting chronic care management.
The announcements, on the eve of the HIMSS 2024 conference in Orlando, speak to the rapid state of AI development and deployment, as well as the pressure put on healthcare executives to address problems that are affecting their doctors, nurses, and patients.
WellSpan Health announced this week that it will be deploying Nuance’s DAX (Dragon Ambient eXperience) Copilot throughout the eight-hospital, 220+ care site health system to improve documentation during exam room and telehealth visits. The AI tool is designed to capture provider-patient conversations and create clinical summaries that the care provider can review immediately after the visit and enter into the EHR.
“We have long recognized the central importance of the quality of each patient’s experience in every interaction with our health system and especially with their primary care and other providers,” Hal Baker, SVP and chief digital and information officer for the Pennsylvania-based health system, said in a press release. “With DAX Copilot, we [are] … giving our clinicians additional state-of-the-art tools to lessen administrative burdens, reduce the time needed to complete documentation, enhance their ability to deliver high-quality personalized care and expand access to care. Patients also appreciate the benefits of DAX Copilot knowing that they have their doctor’s full and undivided attention during their visits.”
WellSpan and Nuance, part of Microsoft’s stable of tech companies, have been working together for several years, with an earlier version of DAX deployed in 2020. Health system officials say a survey of providers found that 94% said the technology improved the quality of their interactions with patients, while 85% said it improved their work-life balance.
UMass Memorial Health and Google Cloud, meanwhile, are joining forces to leverage AI and other tools in the treatment of patients living with cardiometabolic diseases, including heart disease, diabetes, kidney disease and obesity.
"Our mission is to provide the best possible care to our patients, and this partnership with Google Cloud is a significant step forward,” Michael Hyder, MD, MPH, executive director of the UMass Memorial Center for Digital Health Solutions and an associate professor of Cardiovascular Medicine, said in a press release issued this week. “By using data-driven insights to identify patients who would benefit from advanced cardiometabolic therapies, we aim to elevate the high standard of care we provide."
And Intermountain Health and Memora Health are partnering to integrate the latter’s technology platform into the 33-hospital, 400+ site health system’s EHR, initially to automate tasks and improve care management for oncology care teams and patients before expanding to other departments.
“The moment a person is diagnosed with cancer, their life changes,” Derrick Haslem, MD, Intermountain’s senior medical director for cancer care, said in a press release issued on Tuesday. “Being able to provide consistent communication with patients to address questions and concerns about their care is critical and very important to us. Memora’s technology helps our busy care teams with daily tasks and empowers them to focus on what matters most: delivering high-quality care to our patients.”
The partnerships point to a need for healthcare organizations to put AI to work now, rather than waiting for governance to catch up.
The Coalition for Health AI (CHAI) is staking its claim as the industry’s best option for creating meaningful and acceptable AI standards
As the drumbeat grows for AI governance, one of the biggest questions is whether the healthcare industry or the federal government should take the lead.
An almost-year-old coalition of health systems and tech companies is addressing that question with plans to work with federal regulators.
The Coalition for Health AI (CHAI), which formed in April 2023 as a collective featuring Stanford, the Mayo Clinic, Vanderbilt, Johns Hopkins, Google, and Microsoft and now comprises more than 1,300 members, recently unveiled its first CEO and board of directors. The group also announced plans to collaborate with both the National Health Council and health standards organization HL7 to “craft a comprehensive framework for the deployment and management of artificial intelligence (AI) within healthcare settings.”
"AI is transforming the practice of medicine in ways that seemed unimaginable just two years ago,” CHAI co-founder John Halamka, MD, MS, president of the Mayo Clinic Platform and chair of the group’s new board of directors, said in a press release. “CHAI will bring together policymakers, technologists, healthcare providers, health plans, and a range of stakeholder advocates to develop guidelines and frameworks for evaluating AI. We have a shared mission to empower clinicians and patients with AI tools that maximize benefit and minimize harm."
The partnership is the latest and largest effort to date to create guardrails around the fast-growing phenomenon of AI in healthcare. Health systems and hospitals are launching AI programs by the hundreds to address administrative and clinical pain points, but many worry that they’re going too fast too soon.
The Biden Administration has been pushing for a combined approach to AI governance, with an October 2023 Executive Order that puts the Health and Human Services Department and the Office of the National Coordinator for Health IT (ONC) at the forefront of regulatory efforts and a December 2023 final order that calls for more rules around transparency by the end of this year.
CHAI’s efforts have drawn support from US Food and Drug Administration (FDA) Commissioner Robert Califf, who spoke about AI at CES 2024 in January and addressed CHAI at a meeting earlier this week.
“As part of our AI strategy, the Agency is collaborating with public/private partners to develop a framework for assessing the potential risks and benefits of healthcare AI—this issue is too large to be contained within the FDA,” he told the group. “We’re also developing guidelines for the responsible deployment and ongoing monitoring of AI-driven health care solutions, including those using both adaptive and generative AI methods. The aim is to adapt general AI regulation and standards where needed to the unique characteristics of the health care sector. For instance, general AI regulations often stress the importance of accountability and transparency, which are also crucial in the health care domain due to the sensitive nature of health-related data.”
But Califf also said he worried that health systems “do not have the infrastructure and tools to make the most important determinations about whether an AI application is ‘effective’ for health outcomes.” He listed two conditions for proper review of AI tools:
First, the industry and federal regulators will need to monitor AI tools continuously, since the technology is constantly evolving and the threat of drift over time. “With the proliferation of AI applications and the fact that they evolve over time, it is unclear how the performance of the models will be monitored at the scale that will be needed,” he noted.
Second, AI governance must include complete follow-up of the population affected by the AI tool. “The lack of an interoperable national approach to enabling follow-up of patients leads to a situation in which none of our health systems have a systematic ability to do the requisite monitoring of the model except for the duration of an acute care hospital admission,” Califf pointed out.
Califf also sounded a note of caution on “effectiveness” metrics for AI evaluation, saying he worried those analyses might focus on a health system’s financial interests rather than whether the technology can improve clinical outcomes.
Aside from appointing MITRE co-founder Brian Anderson, MD, senior advisor for clinical trial innovation at ARPA-H and an associate professor of biomedical informatics at Harvard, as CHAI’s CEO, the group named a board of directors, led by Halamka, and advisory boards focused on health systems and providers, patient and community advocacy, the healthcare industry, start-ups, and the government.
