Memorial Healthcare System’s new $1.7 million Care Coordination Center aims to eliminate gaps in patient navigation and care management.
The new Care Coordination Center at Memorial Healthcare System is expected to boost care quality and patient safety, the CMO of the health system says.
The South Florida health system invested about $1.7 million in the 3,000 square foot facility and equipment. The annual cost of operating the center is estimated at $3.7 million.
The Care Coordination Center has five primary capabilities, according to Aharon Sareli, MD, executive vice president and CMO at Memorial Healthcare System.
At Providence, AI governance addresses several issues such as safety and security of patients and their data.
Providence is taking a comprehensive approach to AI governance, the health system's chief clinical officer says.
"Our approach to the use of AI tools is methodical and anchored in our mission, values, and organizational vision and priorities," says Hoda Asmar, MD, MBA, executive vice president and system chief clinical officer for Providence. "While we believe AI advancements have the potential to elevate quality of care and allow our caregivers to perform at the top of their license, the safety and security of our patients and their data will always be our top priority."
HealthLeaders is conducting its AI in Clinical Care Mastermind program through December. The program brings together nearly a dozen healthcare executives to discuss their AI strategies and offerings. As part of the program, each of the panelists are talking with HealthLeaders about the use of AI in clinical care.
According to Asmar, Providence has established AI governance to get ahead of several issues raised by AI models,
"Providence proactively assembled an AI governance structure to ensure alignment around priorities and strategy, and ensure safety, privacy, security, equity, and the ethical use of AI," Asmar says. "This governance structure will evolve as our experience and knowledge around AI deepens."
The AI governance structure has several elements, Asmar explains.
"Providence has put together an AI guardrails workgroup led by our system's chief data officer; an Information Protection committee led by our chief information security officer; and a Data Ethics Council, led by our chief ethicist," Asmar says. "The work of these three teams feed into the Generative AI Leadership Council that oversees our responsible use of AI and advances our AI strategy."
The health system has also convened expert groups to manage AI governance, Asmar explains.
"We have stood up four subject matter expert groups: clinical, patient and consumer, workforce and administration, and back office," Asmar says. "These groups identify and prioritize key use cases for their areas and leverage the guardrails, data protection, and other governance structures to guide work to develop and implement AI solutions."
Hoda Asmar, MD, MBA, is executive vice president and system chief clinical officer for Providence. Photo courtesy of Providence.
AI models at Providence
The health system is integrating AI tools into daily work to accelerate decision-making, simplify workflows, and reduce non-clinical task burdens.
This includes internally generated innovations that leverage AI to enhance patient experience and reduce clinician burnout, according to Asmar.
"Some examples include automating non-direct patient care tasks in the form of ambient documentation; clinical decision support by bringing together multiple information sources in a way that allows the clinician to easily analyze and make decisions; and employing predictive analytics that speed up access to just-in-time data and information," Asmar says.
An AI tool developed at Providence helps to manage patient messages sent to clinicians' electronic in-baskets.
ProvARIA (automated realtime in-basket assistant) organizes inbox messages to physicians and caregivers in the ambulatory setting based on acuity, urgency, and content. The AI model uses a natural language processing engine to organize the messages, and a tailored user interface integrated into the electronic health record.
"ProvARIA supports clinicians in responding to their in-basket messages by augmenting them and supporting them in understanding a patient in-basket message, triaging, and responding to the message more readily," Asmar says." ProvARIA has not only eased the way for our care teams but also improved the response time to patients by 50%."
AI's impact on Providence care teams
Some of the clinical AI tools being used at Providence are still new, and the health system is assessing how they are impacting care teams.
"Early indicators suggest these tools have a high level of engagement and satisfaction with the care teams by allowing clinicians to spend more time with their patients, reducing stress and administrative task burdens, and allowing clinicians to focus on what matters most to them and their patients," Asmar says.
Computer-assisted physician documentation and ambient technology, in which physician-patient conversations are automatically transcribed and uploaded directly to EPIC and Providence's EHR through tools such as Nuance's DAX, remove the technological barrier that typically inhibits personal connection in exam rooms and allows caregivers to deliver even better care, according to Asmar.
Providence has also introduced MedPearl, a clinician education and referral platform designed by clinicians for clinicians, which gives primary care providers advice on whether—and where—to send patients for specialty care, Asmar says. Generative AI is used to accelerate content creation and enhance the end user's search experience.
Another example of an AI tool that is having a positive impact on care teams is an AI-powered surgical scheduling tool, according to Asmar.
"Surgical teams have indicated improved role satisfaction as surgery scheduling is easier and more efficient, and this satisfaction is also shared by the surgeons and their office staff," Asmar says.
The HealthLeaders Mastermind program is an exclusive series of calls and events with healthcare executives. This Mastermind series features ideas, solutions, and insights on excelling in your AI programs.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
Memorial Healthcare System's new $1.7 million center aims to eliminate gaps in patient navigation and care management.
The new Care Coordination Center at Memorial Healthcare System is expected to boost care quality and patient safety, the CMO of the health system says.
The South Florida health system invested about $1.7 million in the 3,000 square foot facility and equipment. The annual cost of operating the center is estimated at $3.7 million.
The Care Coordination Center has five primary capabilities, according to Aharon Sareli, MD, executive vice president and CMO at Memorial Healthcare System.
The facility will act as a transfer center, with access to real-time data across the health system's six acute-care hospitals. A team including nurses stationed at the center will be able to coordinate patient transfers both within the health system and from other facilities into the system.
Working through the Epic EHR platform, staff at the center can centralize bed placement. Staff at the center can also balance and manage capacity within each of the six hospitals and ensure that patients transferred into the health system are placed in the appropriate care setting.
Staff members at the facility will conduct virtual patient observation. The primary responsibility of virtual patient observers is to keep an eye on inpatients who are at risk of falls.
The facility will serve as a hub for virtual nursing. Through two-way communication tools at the bedside, virtual nurses can do some of the admissions intake for patients as well as discharge instruction and education. This frees up bedside nurses to do other patient care duties. The goal of virtual nursing is not only to be a satisfier for patients but also a satisfier for bedside nurses.
The facility will manage a centralized staffing pool for nurses, therapists, technologists, and other healthcare workers. That team will use Epic dashboards that have real-time information on high patient volume, then shift staff to areas with high need.
Sareli says the new center addresses a need to improve care management and coordination.
"It was essential for us to leverage technology, people, standard processes, and innovation to put together the Care Coordination Center to lock down multiple processes, including our capacity management for patients, patient transfers, virtual patient observation, and virtual nursing," he says.
Improving safety, care quality
The facility is expected to drive positive outcomes, Sareli explains.
"Ultimately, we not only want to improve patient experience but also improve quality and safety for our patients," he says.
"What we are looking to do is get the patient as quickly and efficiently as possible to the right care destination," he says. "For example, if a patient needs to be in the ICU to receive intensive care, we want to get that patient out of the emergency department as quickly as possible. Getting the patient into the right environment is always going to enhance patient safety and quality."
One critical function of the center, Sareli adds, is to track and improve the patient journey from beginning to end.
"When we look at throughput in our health system and the way patients transition from entry and exit at a hospital, anytime we can do anything to improve efficiency will improve quality and safety," he says.
Improving management of staffing will drive positive outcomes, according to Sareli.
"We have a relatively innovative strategy to have teams look at staffing," he says. "They can identify places in the health system that have increased patient volume and increased needs, then send more staff to the bedside in areas that need more staffing. This also contributes to patient safety and quality."
This also extends to virtual nursing.
"This capability is not replacing the bedside nurses, but the bedside nurses are better able to focus on delivering care," he says. "The virtual nurses can get the right intake information and give the right discharge instructions. This improves quality and safety."
Photo: Dashboards display real-time data at Memorial Healthcare System's Care Coordination Center. Photo by Michael Hopkins Photography.
RWJBarnabas Health executive says lawmakers should enact a permanent, annual inflation-based update to Medicare physician payments.
Congress should intervene to block a 2.8% physician payment cut in the 2025 Medicare Physician Fee Schedule, the CMO of a New Jersey-based health system says.
On July 10, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for the 2025 Physician Fee Schedule that included a reduction in the conversion factor for physician reimbursement from $33.29 this year to $32.36 next year. The conversion factor is the number of dollars assigned to a relative value unit (RVU), which is a key element of physician payment by Medicare.
CMS issued the Final Rule for the 2025 Physician Fee Schedule last week, including the 2.8% physician payment cut.
Congress should adopt a proposal from the American Medical Association to enact a permanent, annual inflation-based update to Medicare physician payments, says Andy Anderson, MD, MBA, executive vice president and chief medical and quality officer at RWJBarnabas Health.
"An annual inflation-based update would provide predictability, and this increased certainty would enable more financial resources to invest into both physician practices and into the recruitment and retention of physicians who are in short supply," he says.
If the physician payment cut is allowed to stand, it will have a severe negative impact on health systems, hospitals, and physician practices, according to Anderson.
"Cutting physician reimbursement will put added financial strain on the healthcare industry and limit the ability to recruit and retain the best and the brightest physicians and staff," he says. "Pay cuts will increase physician burnout, put strain on physician practices, and impede the ability for healthcare organizations to shift to value-based care and focus on health and prevention."
This physician payment cut comes despite CMS estimating a 3.5% increase in the Medicare Economic Index, which is the government’s measure to gauge increases in the costs of physicians delivering care to Medicare patients. The 2.8% pay cut is unsupportable given the estimated increase in care costs, Anderson explains.
"A 2.8% pay cut is not sustainable given the ongoing increases in the costs of healthcare," he says.
The pay cut will prompt healthcare organizations to make hard decisions, according to Anderson.
"Hospitals, health systems, and physician practices will have less resources available and will be challenged to provide needed services and access," he says. "Physician practices will have a harder time retaining staff, will have to cut services, and will be unable to purchase equipment and supplies."
Healthcare leaders should not think about technology first and the allure of AI, says Sutter Health's Kiran Mysore.
Sutter Health’s AI leader says clinicians may be too optimistic about what the technology can do, and they need to understand that there are right and wrong ways to use AI.
“AI is very complex,” says Kiran Mysore, MS, chief data and analytics officer at the northern California health system and a participant in the HealthLeaders Mastermind program on AI in clinical care. “It is rarely a turn-key solution, where you adopt a model and expect it to work.”
“It needs a lot of good, clean data. It needs a lot of talented and skilled professionals to make it work the right way,” he says. “It needs the right workflow integration, and it should impact the point of care. And it needs to be trusted and dependable, which means you must tune the models well so they can predict the right answers.”
Making a business case for hiring new infection preventionists starts with gathering data on the current state of infection rates and staffing concerns.
Infection preventionists have an expertise that is different from physicians and nurses.
They are trained in hospital epidemiology as well as sterilization and disinfection of reusable medical instruments, and they are valuable members of a CMO's clinical care staff.
An infection prevention and control executive at Boston Children's Hospital recently made a business case for hiring more infection preventionists and was able to gain approval to increase staffing by more than 50%.
"Infection preventionists add a lot of value," says Jennifer Ormsby, DNP, RN, senior director of infection prevention and control at Boston Children's Hospital. "They have an expertise that is very different from a nurse or a physician. They can improve patient safety and patient care."
Infection prevention and control programs at healthcare organizations are often understaffed, according to Ormsby.
"Nationally, infection prevention teams are understaffed," Ormsby says, "and the Association for Professionals in Infection Control and Epidemiology and infection preventionists across the country have been advocating post-COVID for C-Suite leaders to have more infection preventionists in their healthcare facilities."
At Boston Children's Hospital, there was a shortage of infection preventionists in ambulatory and procedural settings, and Ormsby led an effort to build a business case for increased staffing.
"Creating a solid business case to build your infection prevention program is key," Ormsby says, "especially when you are working with the C-Suite and advocating for additional resources."
Ormsby took a data-driven approach to building a business case for more infection preventionists. The process started with an assessment of the current state of the hospital's infection prevention and control program, including hospital-acquired infection rates as well as process measures such as hand hygiene, personal protective equipment audits, and the most recent accreditation survey results.
"I was able to present our current state, a bridge to the right size for our department, and right-sizing for our enterprise," Ormsby says.
Part of the business case was detailing overtime payments to the existing infection preventionist staff. According to Ormsby, the hospital was paying about $23,000 in overtime for the infection preventionist on-call staff member and $25,000 in overtime for contact tracing.
"My business case was sharing all the data, and the goal was to prevent infections and improve safety for our patients in procedural and ambulatory settings," Ormsby says. "If I didn't have the resources to be present in those locations to do observations and do quality improvement initiatives, I could not reduce infections."
Before presenting the business case, Ormsby had eight infection preventionists. After presenting the business case, she was able to hire four new infection preventionists and a manager of infection prevention.
Being fully staffed benefits the hospital and its patients because it allows the health system to help patients in all settings, according to Ormsby.
"Historically, the focus has been on inpatient settings as opposed to procedural and ambulatory settings," Ormsby said. "This is a challenge because more care is moving to the ambulatory setting such as day surgery. We need infection prevention staff members in those settings as well."
In addition to making a business case for more staff, there is a business case for limiting infections in healthcare settings, according to Ormsby.
"The business benefits of reducing infections for the organization include not getting reimbursement if an infection is identified as a hospital-acquired infection," Ormsby says. "Payers also can refuse to reimburse hospitals for surgical site infections."
Healthcare leaders should think about business value first in the face of AI’s allure, says Sutter Health’s Kiran Mysore.
Sutter Health’s AI leader says clinicians may be too optimistic about what the technology can do, and they need to understand that there are right and wrong ways to use AI.
“AI is very complex,” says Kiran Mysore, MS, chief data and analytics officer at the northern California health system and a participant in the HealthLeaders Mastermind program on AI in clinical care. “It is rarely a turn-key solution, where you adopt a model and expect it to work.”
“It needs a lot of good, clean data. It needs a lot of talented and skilled professionals to make it work the right way,” he says. “It needs the right workflow integration, and it should impact the point of care. And it needs to be trusted and dependable, which means you must tune the models well so they can predict the right answers.”
HealthLeaders is conducting its AI in Clinical Care Mastermind program through December. The program brings together nearly a dozen healthcare executives to discuss their AI strategies and offerings. As part of the program, each of the panelists are talking with HealthLeaders about the use of AI in clinical care.
Understanding the complexity of AI is one of six pieces of advice that Mysore offers for health systems embracing the technology in clinical care. The other five are:
You need to lead with the business problem or the clinical care problem you are trying to solve with AI first, before thinking about the technology. In some cases, the answer to the business problem may not even be AI.
In cases where AI is a solution to a problem, be very specific about the outcome you want to drive with AI. Focus on integrating AI into clinical workflows, measuring the outcomes over time, and understanding the improvements you are making against a baseline.
You should try to think about scale on Day 1. Don't wait until an AI pilot is done to think about the next step, because scaling takes a long time. If you don't think about scale and performance on Day 1, you lose momentum with your stakeholders.
Use best practices across the board and from the start. Talk with other healthcare organizations that have adopted AI models to learn from them, so you can capitalize on opportunities and avoid making mistakes.
The biggest pitfall is being too optimistic about AI. We are in the early days of AI initiatives. It is rarely going to work exactly as advertised because every use case in every health system is unique. You must think about challenging each promised AI capability. The pitfall is thinking that AI is a silver bullet, and that it will work for everyone.
Kiran Mysore, MS, is chief data and analytics officer at Sutter Health. Photo courtesy of Sutter Health.
How AI is impacting Sutter Health clinical care teams
Sutter Health has launched AI capabilities in ambient listening to summarize the conversations between clinicians and patients, suggesting responses to patient messages to clinicians’ electronic in-boxes, and helping radiologists work better with images.
"The opportunity is to educate clinical care teams about AI, the right use of AI, and the responsible use of AI," Mysore says. "We need to integrate AI into day-to-day workflows, whether it is a physician, a nurse, or hospital staff. When you do that well, you can see tremendous benefits."
"Ambient listening is saving our physicians valuable time every day in note taking and documentation," he says. "AI is helping with the cognitive burden on clinicians because they are feeling less stress at the end of the day because AI is helping them do things easily."
AI is also impacting clinical care teams in terms of augmentation, Mysore explains.
"I do not see clinical care teams going away because AI is taking over," he says. "What AI does is to make clinical care teams' jobs easier and it frees up time in their day to elevate patients’ experience. AI can help clinical care teams see more patients."
AI governance
Healthcare organizations often do not think about governance as much as they should in the early days of AI adoption, according to Mysore.
"We need to be transparent about what AI can do and cannot do," he says. "For example, if you are using an AI model that is trained on some patient data, we need to be transparent about what patient population was used to train that model. If the model was trained on a patient population that has different characteristics from where it is being used, then its outputs will not be reliable."
Sutter Health is evolving a comprehensive approach to AI governance, with a core AI governance committee comprised of legal and digital team members.
"On the legal side, the committee is focused on whether we are doing the right thing in terms of privacy, security, patient confidentiality, risk, and compliance," Mysore says. "The digital team is focused on whether we are using the right AI models, whether we are building the right technology infrastructure, and how these models are working."
The health system has participation from other groups in the AI governance mix, including a clinical group and a research group.
"We have a core group and sub-groups that are aligned to promote AI governance," Mysore says. "Depending on the need, these groups can engage each other on a frequent basis to get advice, get validation, and check on monitoring of AI models. The goal is to accelerate building the right AI capabilities."
The HealthLeaders Mastermind program is an exclusive series of calls and events with healthcare executives. This Mastermind series features ideas, solutions, and insights on excelling in your AI programs.
To inquire about participating in an upcoming Mastermind series or attending a HealtLeaders Exchange event, email us at exchange@healthleadersmedia.com.
Physician recruitment and retention is a top issue for CMOs and other healthcare leaders, with the labor market for physicians extremely tight.
Bozek was appointed CMO at the hospital earlier this month. His prior leadership experience at Catholic Health includes serving as systems medical director overseeing the emergency departments at St. Catherine of Siena Hospital and St. Charles Hospital.
A generational change in physicians must be recognized in recruitment efforts, according to Bozek. CMOs need to make sure there is a good work-life balance for the workforce. Physician candidates need to know that leadership understands that family is important and outside-work activities are important.
"For my parents' generation, work came first, and family life came second," Bozek says. "This has shifted, where home life is coming first for many people."
To succeed in physician recruitment, you must have concise job descriptions, Bozek explains.
"If a physician does not know what they are getting into, they are not going to want to take the job," Bozek says. "On job boards and through your human resources department, you need to make sure the job description is clear."
A competitive compensation and benefit package is essential for physician recruitment and retention, according to Bozek.
"If you do not have that, then a physician will find another position that pays more or has better benefits," Bozek says. "So, you need to make sure you know your fair market value."
Strong employer branding is helpful in physician recruitment, Bozek explains.
"If you have a hospital that prides itself on orthopedic care or cardiac care, you should use that to your advantage," Bozek says. "Cite statistics, and say, 'This is why you want to work for us.'"
A streamlined hiring process can be pivotal, according to Bozek.
"Once you get a response from a job board, you want to respond back quickly and set up an interview," Bozek says. "You can set up a virtual interview, but it is even better to have a candidate interview in person, so they can see your facility and be more engaged."
Bozek recommends that CMOs let candidates know they are going to get back to them within two weeks after an interview. Within two weeks, the CMO should either offer the position or get any additional questions answered. Do not let the hiring process drag out because physicians will go elsewhere and find another job.
Additionally, onboarding programs need to be strong, efficient, and streamlined, Bozek explains.
"Onboarding at a hospital takes about three months," Bozek says. "You do not want hitches in the process that extend onboarding to five or six months because a physician might leave."
Physician retention is also multi-faceted and includes several aspects, according to Bozek.
"You need to make sure that physicians are engaged and happy as well as make sure that you are supporting them," Bozek says. "Their director should be supporting them with educational material and making sure physicians have the supplies they need."
Supporting physicians' educational needs is part of a good retention strategy, Bozek explains.
"You should give physicians opportunities for continuing medical education and taking courses," Bozek says. "You want to support physicians in staying up to date on medical knowledge."
Physicians are more likely to stay at a health system or hospital if they are recognized for doing good work, according to Bozek.
"As CMO, I need to be supportive and make sure when physicians are doing good things such as achieving high patient experience scores that I recognize their effort," Bozek says. "Sometimes, recognition comes in the form of monetary rewards and incentives."
Joshua Bozek, DO, is the new CMO of Catholic Health's St. Catherine of Siena Hospital. Photo courtesy of Catholic Health.
Supervising physicians
Bozek and hospital department chairs follow a process to supervise physicians and other clinicians. Every six months, the department chairs do a review of all the providers to make sure they are meeting all of the quality metrics that are within their department. If there are any outliers, that gets called to Bozek's attention.
"The providers have to stay credentialed with us," Bozek says. "So, there are routine evaluations by their department heads."
One of the most difficult responsibilities of a CMO is working with a clinician who is not achieving metrics or having challenges, according to Bozek.
"You need to be open and honest with them," Bozek says. "You want them to change their behavior and know what they are falling short on."
A CMO needs to have these discussions in real time—they can't try to address an outlier clinician six months after an issue arises, Bozek explains.
"Outlier physicians need to give me feedback," Bozek says, "to show that they understand what they are doing is either a problem or they are not meeting certain standards."
The InovaCare initiative features several elements, including enhancing connections with patients, generating a positive patient experience, and creating care pathways for clinical conditions.
Inova Health System has launched an ambitious initiative to transform how patients connect with the organization as well as establish care pathways for clinical conditions, according to John Moynihan, MD, president and chief of clinical enterprise at the health system.
Moynihan is also president of Inova Surgical Services, with oversight responsibilities for the service line across all five Inova hospitals. His prior leadership experience includes serving as chair of the Department of Surgery at Inova Fairfax Medical Campus.
One of Moynihan's top responsibilities is helping to implement the InovaCare initiative at Inova Health System, which Moynihan hopes will improve the ability of patients to access the health system.
"We want care to be more coordinated and more seamless for patients," Moynihan says. "By embracing evidence-based practice of medicine among our specialties and for particular clinical conditions, we believe that we can get outstanding results in our outcomes."
Improving patient experience is a key element of the InovaCare initiative, with an emphasis on the entire patient journey.
"First and foremost," Moynihan says, "we can never forget that in any encounter, we need to be able to have a patient receive our full attention and have the respect of whoever is caring for them."
To boost patient experience in the inpatient setting, Inova Health System has embraced "trio rounding," where the attending physician, the bedside nurse, and the patient round as a unit.
"It reinforces the confidence level that a patient has that his or her entire team understands the patient's goals and the decisions that will be made clinically," Moynihan says. "That makes sure the patient feels they are part of the conversation."
Listening to the patient is critical to improving patient experience, according to Moynihan.
"One of the questions we ask all of our patients is, 'what matters most to you?'" Moynihan says. "That makes the patient feel they are part of the decision-making process, and they can influence the direction of their care."
Respecting patients is essential to generating a positive patient experience in the inpatient and outpatient settings, Moynihan explains.
"We must respect the time that a patient commits to seeing us in the ambulatory setting, respect the schedule, and devote time to meeting with the patient face-to-face," Moynihan says. "Even if it is a telehealth visit, we want our providers to be focused on the patient's needs at the time of the visit."
The InovaCare initiative has multiple channels for communication with patients, and each patient can access the health system differently.
"For some patients, it may be an enhanced digital connection. For others, it might be a phone call," Moynihan says. "Some patients want to connect through email or texting. We must explore all of those options to meet our patients' needs."
Moynihan explains that seeking out patient opinions is another goal of the InovaCare initiative.
"A lot of what we do is going to need to include our patients' opinions to provide us with direction on how we improve the relationship with patients," Moynihan says. "The more we can understand the patients we serve today, the more successful we will be over the long term in designing efficient and patient-focused care models."
John Moynihan, MD, is president and chief of clinical enterprise at Inova Health System. Photo courtesy of Inova Health System.
Care pathways and care models
Establishing care pathways and care models for clinical conditions is a primary goal of the InovaCare initiative.
"We want to provide care that is evidence-based, and that will be dictated by the particular discipline that the patient is looking for care within," Moynihan says. "Whether it is back pain, heart failure, a breast condition, or lung nodule, each of those conditions will have evidence-based care models that allow for us to take care of the patient with evidence-based medicine."
Having care pathways and care models, which will be incorporated into the health system's electronic medical record, will reduce variation in clinical care. Moynihan hopes that standardizing care based on evidence and building care pathways into the electronic medical record will allow Inova to standardize care and measure the ability to deliver better outcomes.
"It has been well established that reducing variability in care achieves better outcomes," Moynihan says. "Reducing variability in care is also a more efficient way to care for patients."
To establish care pathways and care models, the health system brings together primary stakeholders at the start of the process.
"As we gather evidence that supports a particular pathway, we bring physicians, advanced practice providers, and nurses to the table and walk through what a care pathway might look like," Moynihan says. "We get their feedback, then come to a consensus about how we are going to execute a care pathway."
Crucial AI governance capabilities include understanding how AI tools are being used and monitoring of AI tools to reduce or eliminate unintended consequences.
Health systems should put a governance structure in place early in their AI adoption process, a top executive at Community Health Network says.
"You need to have the governance in place to make sure that you understand all of the tools that are being used, how the tools are being used, the intended outcome of usage, and how you mitigate bias," says Patrick McGill, MD, MBA, executive vice president and chief transformation officer of the Indianapolis-based health system. "Having a governance structure in place from the beginning is helpful."
HealthLeaders is conducting its AI in Clinical Care Mastermind program through December. The program brings together nearly a dozen healthcare executives to discuss their AI strategies and offerings. As part of the program, each of the panelists are talking with HealthLeaders about the use of AI in clinical care.
CHN recently hired a director of AI and data governance, who will be standing up an executive steering committee to help identify and prioritize AI tools and use cases.
The members of the executive steering committee will include McGill along with the health system's CFO, CMO, chief physician executive, chief information officer, and technical staff from IT and analytics.
"The focus of the executive steering committee will include prioritization of projects; implementation and use of policies, procedures, and traditional governing functions that must be put in place; resource allocation; and oversight of the monitoring of AI tools to reduce or eliminate bias and other unintended consequences of AI," McGill says.
Monitoring is a crucial AI governance function and varies based on various AI tools, McGill explains.
"Some of the monitoring will be through data reports," he says. "Some of the monitoring will be third-party partnerships to monitor the performance of an AI model. A third approach to monitoring will be to understand how third-party partners are using our data—we want to know whether data is de-identified, whether data is going out to a publicly available large language model, and what data the AI model is built on."
Prior to establishing the executive steering committee, the health system began the process of creating AI governance capabilities, according to McGill.
"We have put in policies, procedures, and guardrails for the appropriate use of AI," he says.
Patrick McGill, MD, MBA, is executive vice president and chief transformation officer at Community Health Network. Photo courtesy of Community Health Network.
Community Health Network's AI models
Like most health systems that have adopted AI tools, CHN is using ambient listening and ambient documentation to decrease administrative burden on clinicians.
"We partnered with DAX Copilot for the past year and a half, so we are using that technology across almost all of our outpatient specialties," McGill says. "It is helping people document faster and get out of the clinic faster. They can close their charts efficiently."
The health system recently adopted Secure GPT via a partnership with Qualified Health, which is HIPAA compliant. Clinicians can use the AI model to ask clinical questions and put in clinical information if they need to generate a letter.
"Clinicians are using it for note summarization and rapid look-up of clinical information such as the maximum dose of a certain medication," McGill says. "It is helping clinicians to get quick answers. Clinicians are using it for clinical workflows such as generating a consult letter or generating a summary—any information they might need to make the clinical workflow be more efficient."
One of the newer AI tools that CHN is adopting in a partnership with Notable, McGill says, will help streamline clinical workflows.
"For example, it will read a mammogram, identify whether the patient has an abnormality and needs additional imaging, and initiate a referral for the additional imaging," he says. "If the patient needs additional follow-up such as a breast MRI in six months, the AI tool will identify that need, then generate a referral for that follow-up."
Radiology is the focus for this AI tool now, but there are potentially other use cases with lab reports and procedure reports, McGill says.
Another new AI tool that the health system is piloting can conduct chart summarizations specific to a clinician—what the clinician's preferences are and what the clinician needs to know or wants to know before walking into a room to see a patient.
"This AI tool will automate a lot of manual work, and it is reading the chart to pull out nuggets of information that previously you had to have a human do," McGill says.
AI impact and advice
The health system's clinical care teams are giving positive feedback on the adoption of AI tools, according to McGill.
"AI is taking administrative work off their plate," he says. "It is removing administrative burden and allowing clinicians to focus more on taking care of patients. Often people are resistant to using new technology, but the feedback that we are getting on our AI tools has been welcoming."
In addition to establishing governance capabilities early in a health system's AI journey, McGill offers two pieces of advice to others who are adopting AI tools.
"One, you must include the clinicians in AI adoption from the beginning," he says. "Two, you must be willing to take chances. These tools are new, and they are not perfect, but they are only going to continue to get better. If you are only going to move forward with perfection, the train is going to go past you."
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Hoda Asmar, MD, MBA, is executive vice president and system chief clinical officer for Providence. Photo courtesy of Providence.
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