The Joint Commission announced this week that it's working with the Coalition for Health AI on a new collaboration to develop a set of healthcare AI best practices and promote their adoption at hospitals and health systems nationwide.

WHY IT MATTERS
TJC, which sets healthcare standards and accredits more than 23,000 healthcare organizations across the U.S., says it will work with CHAI – a nonprofit founded by an array of providers and technology developers to spur standards for responsible AI – to co-develop new tools and playbooks toward those goals.

They'll also create a "new certification program rooted in The Joint Commission's platform for evidence-based standards, and CHAI's consensus-based best practices for health AI," according to the announcement.

They said the first guidance will be available in fall of 2025, with the AI cert program to follow.

THE LARGER TREND
The two groups point to recent research that shows adoption of AI in healthcare is proliferating across a wide array of use cases, from workflow automation to predictive analytics and patient monitoring to drug approvals. Some 46% of American healthcare organizations are in initial implementation of generative AI, they note.

But approaches to AI implementation still vary widely, and health systems are seeking concrete guidance to help "protect their staff, patients and operations," according to TJC and CHAI.

"This effort between The Joint Commission and the Coalition for Health AI represents a thoughtful approach to navigating how to best deploy and implement these emerging technologies," said Dr. Michael Pfeffer, chief information and digital officer at Stanford Health Care, in a statement

"This partnership, the guidance, tools and certification it aims to provide will help accelerate innovation, mitigate risk, and enable healthcare organizations to fully leverage AI's potential to improve patient outcomes and clinician workflows," he added.

Just this week, Stanford unveiled its own new generative AI tool, ChatEHR, which Pfeffer said will offer "new way for clinicians to interact with electronic health records." (Watch our 2023 CIO Spotlight interview with him here.)

CHAI, meanwhile, has been busy these past few years, building membership to nearly 3,000 organizations and counting, and launching its open-source "nutrition label" model card transparency tools earlier this year.

ON THE RECORD
"In the decade ahead, nothing has the capacity to change healthcare more than AI in terms of innovation, transformation and disruption," said Dr. Jonathan B. Perlin, president and CEO of The Joint Commission. "While it's impossible to predict exactly what healthcare will look like over that time, AI's integration and potential to improve quality patient care is enormous – but only if we do it right." 

"Partnering with The Joint Commission means we can help healthcare organizations utilize AI and the many benefits these new technologies bring, at a scale we have never been able to achieve before," added Dr. Brian Anderson, president and CEO of CHAI. "Together, we're leading the transformation of data-driven healthcare, one where AI is embedded into every healthcare program – regardless of population, geographic area, or resources – to elevate patient safety and quality, and ultimately improve health outcomes for all."

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication. 

Aidoc and NVIDIA have developed an open-source framework designed to help chief information officers and governance leaders at health systems manage the fragmentation – across vendors, evaluation processes and IT strategies – that invariably arises with the emergence of artificial intelligence for clinical uses.

The new framework, called BRIDGE, could help standardize validation, interoperability, scalability, deployment and continuous monitoring to aid healthcare systems in achieving faster and more successful AI adoption, said Aidoc in Tuesday's announcement.

WHY IT MATTERS

BRIDGE stands for Blueprint for Resilient Integration and Deployment of Guided Excellence. The framework aims to help resolve the lack of shared definitions and AI deployment expectations and offers health systems and their vendors a clear, consensus-driven foundation for assessing and integrating machine learning platforms into healthcare delivery.

Built in collaboration with NVIDIA, the framework outlines the technical, regulatory, operational and trust-building criteria that AI tools must meet to be deemed healthcare-ready.

BRIDGE can give health systems the structure they need to implement AI safely and responsibly, according to Dr. Efstathia Andrikopoulou, echocardiography medical director at Harborview Medical Center and associate professor of medicine and collaborative intelligence at the University of Washington.

"Deploying AI at scale requires more than technical performance," she said in a statement. "It requires trust, transparency and system-level readiness."

In addition to Andrikopoulou, experts from University Hospitals and Ochsner Health contributed to the roadmap, Aidoc said. 

"We're at a point where AI in healthcare must mature from experimentation to integration," added Dr. Leonardo Kayat Bittencourt, vice chair of innovation in the University Hospitals Department of Radiology. 

The framework guides hospitals navigating the use of clinical AI in differentiating between models and software systems, establishing best practices to ensure a minimum viable production environment, incorporating trust-building mechanisms and scaling systems.

THE LARGER TREND

While AI is already being used more often at the point of care, Aidoc and NVIDIA endeavored in October to create a plan to speed health AI adoption by developing an evidence-based framework. 

Aidoc is a vendor of AI tools that integrate real-time insights directly into clinical workflows to help providers close care gaps and accelerate patient access to treatment. NVIDIA offers numerous microservices that can be run from the cloud or on-prem to integrate generative AI into existing applications, focusing on a variety of healthcare use cases, including genomics, imaging and other care delivery priorities, such as predicting hospital readmissions.

By developing BRIDGE in collaboration with providers, academic partners and other industry leaders, Aidoc and NVIDIA said they were striving to build on real-world health AI and focus on common challenges experienced through existing clinical AI integrations. 

ON THE RECORD

"To safely deploy AI in healthcare, we need more than strong algorithms," Reut Yalon, Aidoc's chief product officer, said in a statement. "We need shared structure. … It helps the industry align on what 'good' looks like so we can accelerate adoption without compromising safety or performance." 

Kayat Bittencourt added, "BRIDGE gives health systems the foundation they need to scale AI responsibly and the language to do it together."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.

The University of Massachusetts Chan Medical School and the incubator at Red Cell Partners will soon test and certify healthcare artificial intelligence products under a two-year collaborative agreement that allows university researchers to evaluate select healthcare AI products from the firm's investment portfolio. 

WHY IT MATTERS

With UMass Chan becoming an established member of Red Cell’s Partners Advancing Critical Technologies program, the university's Health AI Assurance Laboratory will begin testing and certifying AI products aimed at enhancing healthcare delivery and regulatory compliance.

Red Cell builds and launches technology-led healthcare, national security and cyber startups, according to Wednesday's announcement. Partnering with the firm will create a pipeline for UMass Chan to evaluate health AI products and establish guidelines for how they are deployed in patient care, according to Dr. Adrian Zai, UMass Chan's chief research informatics officer and co-leader of the Health AI Assurance Laboratory.

"This collaboration enables a rapid yet rigorous pathway to develop, test and evaluate AI tools using real-world clinical data," he said in a statement. 

UMass Chan will supply data used for AI testing through its Center for Clinical and Translational Science’s Research Informatics Core, of which Zai is also director.

THE LARGER TREND

Last year, UMass Chan and MITRE Corp., which also operates the national AI Assurance and Discovery Lab in northern Virginia, launched the Health AI Assurance Laboratory after receiving a $555,000 Massachusetts Technology & Innovation Ecosystem Awards Program award and a private-sector match.

"Current and future healthcare professionals will be able to create and guide AI technology to fulfill its promise of better, more efficient and more equitable patient care across our communities," Michael Collins, chancellor of UMass Chan, said in a statement at the time.

Many organizations, including the Department of Health and Human Services, have been working to operationalize health AI by evaluating the quality of machine learning algorithms to understand their benefits and track where clinical innovation is going. 

However, in December, some members of Congress asked HHS to back away from its years-long effort to establish government-administered health AI testing labs in partnership with industry.

A lack of AI testing and evaluation could prevent providers from implementing advanced disease and risk-prediction models out of fear that they might magnify care inequities, according to Brigham Hyde, CEO of Atropos Health. 

"The burden, I think, that should be on companies like mine and others is to show what the expected action and benefit is," he told Healthcare IT News during a recent HIMSSCast podcast about the need for AI assurance labs.

ON THE RECORD

"Our shared goal is to quickly identify which AI tools are safe, effective and ready for real-world healthcare challenges, and which are not," Zai said in a statement.

"UMass Chan doesn’t just talk the talk of serving the underserved," said Dr. Timothy Ferris, Red Cell’s healthcare practice division president. "They do it day in and day out. And those are the types of people that we want to partner with."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.

Tertiary public healthcare provider St Vincent's Hospital Melbourne has added an extra layer of security in its compounding pharmacy.

For 12 months, it will pilot an AI-driven and cloud-based solution provided by New Zealand-based company Veriphi. The technology uses laser spectrometry to verify intravenous drug identity and concentration at the point of compounding. 

WHY IT MATTERS

SVHM compounds most of the chemotherapy and supportive oncology medicines in-house at their sterile compounding pharmacy. 

In an interview with Healthcare IT News, SVHM chief pharmacist Andrew Cording shared their growing challenges at this facility. 

"Oncology and haematology services continue to experience significant year-on-year growth – far outpacing general demand across the broader public health sector. This growth places continual pressure on compounding services, requiring us to be both efficient and precise while maintaining the highest standards of safety and quality. Balancing this demand with workforce sustainability, quality assurance, and risk mitigation remains one of our biggest operational challenges."

Cording admits that while they follow best practices (including mandatory double-checking of all compounded chemotherapy products and triple-checking), their compounding process remains error-prone. 

"Like all hospitals, we are not immune to workforce pressures; unexpected sick leave, multitasking demands, fatigue, and cognitive overload can all influence performance in a busy and complex environment like a sterile manufacturing unit," he said.  

"While our historical error rate is fortunately very low, the consequences of even a single error in this high-risk setting can be catastrophic. That’s why we are always looking for innovations that reduce reliance on manual checks and further enhance medication safety."

SVHM first engaged Veriphi following a medication compounding error that occurred several years ago. "Thankfully, no harm occurred to the patient, but it prompted serious internal reflection and an important question from our CEO: What more can we do to strengthen safety beyond our current systems?" 

The hospital saw that Veriphi's laser-based technology "aligned closely" with their needs and started collaborating with them to refine and validate it against their compounding workflows. 

"The results have been promising," Cording exclaimed. "The device has successfully identified errors before products reached patients and added a layer of safety that is objective and digital, reducing the cognitive burden on staff."

The chief pharmacist believes that having the ability to verify both identity and concentration of a compounded drug using a real-time, non-invasive process is a "game-changer." "Our primary goal is to further reduce the risk of medication errors in compounded oncology infusions – an area where the stakes are particularly high."

SVHM is now working with Veriphi to expand the application of the analyser to other medicines, as well as other high-risk areas such as paediatrics and clinical trials. "As the technology matures, we’ll continue to evaluate its broader integration into our pharmacy services," Cording added. 

Following its major rollout at SVHM, Veriphi looks to secure supply deals in Australia, New Zealand, and the United States.

THE LARGER TREND

Meanwhile, SVHM has also been involved in the testing of an AI that predicts patient disposition, which refers to a clinician's decision about where patients proceed after presenting to the emergency department, supporting decision-making. The project is being done in partnership with La Trobe University. 

ON THE RECORD

"At St Vincent’s Hospital Melbourne, medication safety is a cornerstone of our pharmacy service. We have a strong culture of continuous improvement and evidence-based innovation. While digital health technologies offer exciting opportunities, we approach them with a critical lens. Any new technology must solve a real-world clinical problem; it must enhance safety, not just add complexity… The goal is not to replace human checks but to augment them with a digital safety net that supports our staff and ultimately protects patients," Cording, its chief pharmacist, said.

Coming out of the COVID-19 pandemic, hospitals and health systems were grappling with a deep and widespread sense of exhaustion across the healthcare workforce. Morale had plummeted, and provider organizations were watching talented, compassionate people leave the industry altogether.

THE CHALLENGE

"It was more than just burnout; it was disillusionment," said Shelley Parn, chief human resources officer at OSF Healthcare, a health system headquartered in Peoria, Illinois, and employing almost 26,000 clinicians and staff in 160 locations in Illinois and Michigan. "The environment felt like still water – stagnant and heavy. There was a palpable sense that something had to change.

"I didn't need data to tell me we had a retention problem – our people were telling us with their feet," she continued. "But the data confirmed the urgency. What became clear to us at OSF was that if we wanted to attract and retain the best people, we had to show that we truly cared."

Cared not just about the work they do, but about who they are as individuals, she added.

"That meant going beyond surface-level perks to reimagine our 'mission partner' value proposition," she explained, using the term OSF has for clinicians and staff. "We had to shift the experience of being a mission partner at OSF from something people inherit to something they choose – and keep choosing every day because they see a long-term path for themselves inside the organization."

OSF Healthcare set a goal to become the employer of choice in every community it serves. That required a new approach – one rooted in development, choice and care for the whole person, Parn said. To help with this goal, the organization turned to Guild, its education benefit and talent development company that deploys a data-driven talent development platform.

"It's a way we've been able to implement our commitment to invest in our people's growth, their education and their future careers with us," she said. "We've found when people feel seen, supported and empowered, they stay and they thrive."

PROPOSAL

When OSF Healthcare looked at the turnover and burnout challenges it faced, it became clear that simply hoping for improvement wasn't enough. It needed a strategic solution to the problem that supported its clinicians and staff while aligning with its organizational goals and long-term workforce needs.

"The proposal from Guild was compelling because it gave us a way to deliver a meaningful return on our investment in education while centering around the experience of our mission partners," Parn said. "At its core, the proposal reimagined our education benefits with choice and accessibility in mind.

"We revamped our policy from the ground up," she continued. "Mission partners became eligible on day one of employment, removing the old barriers that made education feel like a privilege for the few instead of a pathway for all. We eliminated clawbacks and service time requirements because we understand that life happens, and people may be called to different paths for any number of reasons."

OSF also broadened eligibility to include PRNs and other flexible roles, making it easier for those at the margins to consider full-time employment down the line. Financial barriers were removed entirely in prioritized programs, including the creation of a fully funded nursing pathway.

That meant no upfront costs, no repayment worries – just opportunity. It was a proposal designed not only to support the current workforce but to build a stronger, more resilient talent pipeline for the future.

"Ultimately, this approach wasn't just good for the organization or good for individual mission partners; it was good for the communities we serve," she noted. "As we watched enrollments climb and mission partners successfully progress through programs in our own schools of nursing, it confirmed this was more than a benefit revamp. It was a foundational shift toward a culture of growth, empowerment and shared commitment."

MEETING THE CHALLENGE

OSF Healthcare approached its talent development strategy with intentionality from the very beginning, engaging voices from across its ecosystem – both clinical and nonclinical – to ensure it was designing a solution that met the diverse needs of its clinicians and staff.

"Guild became a way to not only reimagine how we deliver education benefits but to align that effort with the long-term sustainability of our workforce," Parn explained. "One of our greatest strengths is that OSF includes two nursing schools, St. Francis and St. Anthony, both of which have historically maintained some of the highest pass rates in the state.

"However, even with strong outcomes, enrollment had been declining," she noted. "That's where our work with Guild came in. Through our work together, we've seen a 35% increase in enrollment in our nursing schools."

That alone would be a significant success, but it's just part of the story.

"Guild helped us extend our reach beyond local pipelines to target areas of critical need, such as allied health roles, where our talent pipeline was limited," Parn said. "Guild also enabled us to offer direct pay programs, eliminating the upfront financial burden of going back to school and thus opening up access for those who couldn't afford to pay tuition out of pocket and wait months for reimbursement. This has been a huge unlock for us to broaden our talent pool.

"From an operational standpoint, Guild provides reporting to help us track participation, engagement and program outcomes in real time," she continued. "This not only makes it easier to manage the program but also provides data that informs strategic workforce planning. In short, it's a program that respects the needs of our people, strengthens our internal pipeline and ultimately supports our mission partners in their delivery of care."

RESULTS

OSF Healthcare has seen significant results since launching its work with Guild, and the data tells a story of both impact and momentum.

"One of the most telling early indicators is that more than 40% of our new hires created a Guild profile within 10 days of joining OSF, despite it not being a required part of onboarding," Parn reported. "That tells us the offering resonates and that it's addressing the talent attraction and retention challenges we set out to solve.

"It's a clear sign that people are hungry for growth opportunities within healthcare," she continued. "The engagement doesn't stop there – 12% of mission partners have taken the next step by enrolling in a program. Those are powerful numbers, especially when you consider the operational and financial hurdles that often stand between healthcare workers and continued education."

OSF has removed those barriers and created real pathways for people to grow within the organization, she added.

"We've also seen hard, bottom-line impact," she said. "We retained approximately 2,400 mission partners who, by traditional patterns, we would not have expected to stay. That level of retention, especially in the wake of COVID-era burnout, is a testament to how much people value an employer that invests in their future.

"Additionally, more than 130 internal promotions have been earned by current and prior Guild learners, including more than 50 in nursing and 80 in clinical support roles," she continued. "Finally, the return on investment has been exceptional. We've seen more than a 200% return on every dollar spent on mission partner tuition, with more than 1,500 graduates completing programs through Guild since our launch in 2023."

These results validate the strategy, she said, adding that it's an initiative that is not only good for the teams and the communities served, but also smart for the business.

ADVICE FOR OTHERS

For healthcare organizations considering a talent development platform, Parn's advice is to start with a clear understanding of goals and how this technology can support them.

"Whether you're focused on filling hard-to-staff clinical roles, boosting retention across the workforce or offering broader access as a competitive talent acquisition tool, defining your objectives early will help you shape the right program structure," she said. "With the right vendor, this type of platform is incredibly versatile, but it's only as effective as the strategy behind it. Know what success looks like for your organization before you start.

"It's also important to see this technology as a complement to your existing ecosystem," she concluded. "Many health systems already have strong education stipends, apprenticeships or internal development programs tailored to specific roles. Rather than duplicate those efforts, look for ways the platform and program can fill gaps, expand access or serve different populations."

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

WATCH NOW: How to launch a healthcare AI project, per the VA AI chief

Altera launches new patient tools

This week, Altera Digital Health launched a new patient engagement platform that fully integrates with the existing Sunrise EHR for mid-size hospitals and health systems.

Called CarePath, the technology can help prevent adverse events and hospital readmissions, which often occur in the post-discharge period, by automating communication workflows, Altera said in a statement. The patient-facing system integrates messaging and billing and notifies patients about appointments and medication adherence needs.

"This level of engagement is key to delivering truly patient-centric care," said Jay Adams, Altera's executive vice president and general manager for Sunrise.

Atropos, Databricks link data troves 

Atropos Health, a real-world evidence generation company with a federated data network that has more than 300 million patient records, and Databricks, a data, analytics and AI company, announced early in June that they will collaborate.

They aim to give clinicians and researchers the ability to generate actionable, evidence-based insights from real-world clinical data. Databricks' data intelligence platform and Atropos’ expertise in AI model development will use Delta Sharing to securely and compliantly link massive data sets across the healthcare ecosystem. 

Of note, Atropos recently updated its Geneva OS platform with nodal patient deidentification and query time interval encoding.

"By responsibly and compliantly linking massive data sets in healthcare, we will drive not only better outcomes for patients, but a seamless user experience for healthcare researchers and providers,"  said Dr. Brigham Hyde, CEO and cofounder at Atropos Health.

Elation adds agentic AI 

Elation Health has added AI that automates post-encounter tasks in primary care, which is built on its genAI note assistant. Called Actions, the tool identifies and categorizes actionable next steps mentioned during patient encounters.

For example, if a physician suggests a lab order for a patient's A1c, or plans to refer the patient to cardiology, Actions will automatically surface these as tasks for review and sign-off. The company said on its website last week that the agentic AI tool will reduce administrative tasks like creating follow-up orders, prescriptions and referrals.

The company said that it understands the clinical context to generate precise tasks, like adjusting a specific medication and dosage. In a survey, 70% of clinicians using Actions with Note Assist reported better focus and engagement with patients, and 65% saved between 5 and 30 minutes per patient encounter. 

Testing Apple vision tech 

Cosmo Pharmaceuticals announced that in July, it will initiate its first usability study of a medical device software application connecting Medtronic's AI-powered platform for the GI Genius endoscopy module with Apple Vision Pro. 

With AI, Medtronic's platform increases the adenoma detection rate of colorectal polyps by as much as 14.4%, Cosmo said in the statement.

The study, led by Dr. Irving Waxman at Rush University Medical Center in Chicago, will evaluate real-time use during live colonoscopy procedures. Doctors will be testing access to AI-generated insights through Apple Vision Pro glasses, without looking away from the operative screen.

"What Cosmo has built by connecting the GI Genius module with Apple Vision Pro is extraordinary," Waxman said in a statement. "It has the potential to revolutionize how we practice – by giving us AI-powered insights exactly when and where we need them. This is not just an incremental improvement – it’s a complete reimagining of procedural medicine."

Data-driven respiratory care

Century Health announced that it has made a deal with Nimbus Health to create high-quality, real-world datasets for serious respiratory diseases, with initial focuses on chronic obstructive pulmonary disease and asthma.

Century's AI platform integrates with Nimbus Health pulmonary care clinics' EHRs, curating data from unstructured clinical notes for use in clinical registries. The enhanced datasets it creates will generate insights into patient profiles, disease progression and treatment outcomes, Century said.

AdvancedMD teams with Waystar

AdvancedMD said it is offering its healthcare clients an alternative to Change Healthcare in partnering with Waystar Clearinghouse as part of its summer release including 20 enhancements.

The cloud-based healthcare software for independent medical practices is adding AI integrations to automate essential EHR workflows including genAI patient summaries into formatted notes.

Also this month, AdvancedMD added NGA Healthcare, a platform for independent medical practices that manages payor contracts and negotiates higher reimbursements, to its partner marketplace.

IQVIA trims clinical trial reviews

IQVIA is leveraging agentic AI to significantly accelerate various stages of clinical trials and drug development, according to an announcement from NVIDIA earlier this month. 

The company's new AI orchestrator agents, which leverage the NVIDIA NIM microservices, are designed to streamline complex, time-consuming processes and shorten the traditional 200-day clinical trial startup process. A clinical data review agent identifies data issues early in the process and can reduce review time from seven weeks to two, the company said. 

Palantir, TeleTracking launch hospital tool

TeleTracking Technologies and Palantir Technologies have allied to give hospitals near real-time insights to optimize staffing, accelerate decisions and improve patient care while helping hospitals expand capacity, coordinate care more effectively and operate more efficiently. 

The companies said on June 5 that they will integrate TeleTracking’s Operations IQ platform with Palantir’s Foundry and AI operating system to render healthcare organizations with unprecedented visibility and coordination.

By integrating clinical, operational, financial, workforce and third-party data, they could forecast capacity, staffing and resource management and gain accurate situational awareness across different regions or health systems. The integration will also support operations by reducing workloads and could improve patient and financial outcomes.

LeanTaaS' surgical coordination

iQueue for Surgical Clinics is billed as an industry-first, according to a LeanTaas announcement earlier this month. The new AI-powered, cloud-based system aims to streamline the entire surgical journey from the clinic to the operating room by enhancing coordination, prior authorizations and patient readiness. 

The company said it will help health systems better control costs and improve revenues. The platform integrates with clinic EHRs.

Oracle helps with VBC

Fortify Children’s Health, a Virginia-based pediatric care network, is using Oracle Health Data Intelligence to improve care and manage value-based care contracts more effectively, the vendor said on its website. The network's more than 1,000 providers use numerous electronic health records. 

Oracle's platform integrates and standardizes the EHR data, payer claims, enrollment data and public data from the state's health information exchange and immunization registry.

Clinicians get a more complete picture of each child's health history with unified data and custom scorecards enabling the organization to continuously monitor value-based care metrics. Patients also benefit from identification of their care gaps, which send follow-up alerts to providers, care managers and practice managers.

Over the past two decades, nearly 200 rural hospitals have closed in the U.S., with an additional 700 at risk of closing soon. And with big cuts to Medicaid on the agenda in Congress, spending reductions that could greatly impact the solvency of many rural hospitals, fear is growing among the remaining rural hospitals.

This all is top of mind for Dr. Jennifer J. Bryan, a family medicine doctor at Hattiesburg Clinic in Mississippi and president of the Mississippi State Medical Association. The state has seen a reduction in public health funding by half– slashing almost $240 million.

THE CHALLENGE

This dynamic has placed extraordinary stress on physicians and other healthcare providers, resulting in longer hours, increased patient loads and significant administrative burdens that directly compete with patient care.

"Prior to adopting AI assistant technology, clinicians, including myself, were navigating an overwhelming administrative workload, directly reducing time available for patient interactions and affecting overall care quality," Bryan explained.

"Moreover, rural physicians and other healthcare providers often face additional challenges, such as limited staffing resources, difficulty in recruiting and retaining clinicians, and limited access to sub-specialists," she continued. 

"The resulting clinician burnout and dissatisfaction significantly affect both clinician retention and the quality of patient care provided, thereby intensifying healthcare disparities between rural and urban communities."

The introduction of advanced technologies, particularly those powered by artificial intelligence, became an essential consideration for addressing these pressing challenges, she added.

"The integration of AI technologies offers rural clinicians practical tools to mitigate these overwhelming administrative demands," she said. "This technological support, not only enables clinicians to manage patient care more efficiently, but also directly addresses financial sustainability by optimizing resource allocation and enhancing overall operational efficiency, which is crucial for the long-term viability of rural healthcare facilities."

PROPOSAL

Bryan saw promise in the AI assistant technology from vendor Suki. It was compelling precisely because it addressed the heart of the rural healthcare challenge – administrative overload, she said.

"I was introduced to the technology through professional networks and my clinic system leadership, and I was immediately intrigued by its potential, not merely to automate, but genuinely to augment clinical practice," she noted.

"This technology uniquely promised to streamline the documentation process, reducing the administrative burden on clinicians and enabling more time for direct patient engagement," she continued. "This was essential for enhancing both clinician and patient satisfaction, ensuring physicians once again could focus more on the delivery of healthcare rather than on paperwork."

As a physician deeply engaged in healthcare policy and advocacy, to ensure transparency and accountability in AI use nationally, Bryan approached the implementation of the Suki system with cautious optimism.

"My commitment to responsible AI use meant rigorously evaluating the vendor's capability to make sure it was reliable, accurate, and leaning into emerging ethical and regulatory standards," she explained.

"This has aligned well with my broader goal of influencing national policy to safeguard patients as well as physicians and other healthcare providers from potential AI-related harm," she added. "I believe in the promise of AI and that it is transforming the potential of healthcare in our country and abroad. I equally believe it is our collective responsibility that we are proactive in our safety efforts that as we deploy AI tools, we do so with the patient always top of mind."

Additionally, Bryan's professional background includes ongoing efforts in AI governance and IP strategy to enhance the safety and accountability of clinical AI technologies. Suki's promise of clinician-centric design with strong integration capabilities resonated strongly with her professional strategic objectives.

"It became clear to me that adopting such a sophisticated, well-integrated AI technology could serve as a model for responsible AI adoption within rural healthcare settings and across the nation," she said. "It deeply interested me to adopt technology that met my personal practice needs but also could further meet the needs my rural state has with a public commitment to ethical deployment."

MEETING THE CHALLENGE

Bryan's implementation of the AI assistant into her practice has been comprehensive, making ample use of its integration into the Epic EHR. This design means minimal disruption to existing workflows. The Suki technology integrates into many EHRs, which can lead to more rapid clinician adoption as they experience more ease of use.

"Using the AI assistant, my team experienced notable improvements, including rapid retrieval of patient data directly from the EHR," she said. "It has alleviated much of my time spent typing or dictating, and patients have noticed that I am able to spend more meaningful time with them. I should note that although AI has been extraordinarily positively impactful, the astute clinician must still verify the documentation reflects the spirit of the interactions.

"Realizing that tech is advancing rapidly – and these are tools designed to augment the practice of medicine but not to replace it – this means the clinician critically must still remain in control of their own documentation, maintaining responsibility for what is reflected within it," she added. 

"Ultimately, the healthcare provider should review their notes or other AI suggestions prior to acceptance, and this takes a fraction of the time needed to type, dictate or manually select suggestions."

Doing so ensures the documentation is entirely reflective of the clinician's plan or can be edited, if needed, and is a way to capture the excellence of the AI tool while also providing the human safety net, she added.

"The capabilities have made my practice much more efficient and have allowed me more time with my patients as well as basically freeing me of pajama time documentation at home when I am with my family," Bryan said.

"Additionally, the thoughtful design of Suki's user interface and voice recognition capabilities made it simple to integrate into my daily routine," she continued. "The technology is intuitive, minimizing the typical learning curve associated with adopting new digital health tools."

This ease of adoption has been important for her own sustained use and maximizing long-term benefits, which has enabled her to use it consistently on essentially all of her patient interactions in a way that enhances, rather than disrupts, patient care, she added.

"Simply said, it's easy to use, patients like it, and it makes both the professional and personal aspects of my life easier," she said.

RESULTS

Since adopting the AI assistant technology, Bryan has seen tangible results that have elevated the quality and efficiency of her documentation.

"It has improved the completeness of my documentation and reduced documentation time significantly," she reported. "With this extra time, I can choose to add three or four more patients to my schedule or leave the clinic early to attend one of my children's sports practices or other events.

"It has provided flexibility into my schedule for other professional activities; I am interested in including medical advocacy," she continued. "With less time typing or dictating, I have immediate time built into my schedule to pursue passions that not only help my own practice but stand to help physicians and patients across the country."

Instead of feeling weighed down, it has been like having a helping hand extended to her, she added.

"There is reliable help available," she noted. "The most notable improvement in my practice has been that I am able to provide more attentive and personalized care, which is the core reason most of us entered medicine. I am able to meaningfully connect with patients again."

ADVICE FOR OTHERS

For Bryan, AI is an area of personal expertise and passion. As a national leader of organized medicine, she just shepherded national policy passage in this technology space as to what physicians across the country are calling for, pertaining to the deployment of clinical AI as a tool in their practices.

"Physicians instinctively will gravitate to tools – including AI-based tools – that allow them to experience the joy of medicine again and to free them from the documentation burdens that have really complicated the delivery of care," she said.

"My general advice to organizations considering AI-driven documentation systems is clear: Prioritize integration capabilities, clinician usability, and rigorous and ongoing evaluation of the tool's clinical impact," she continued. "Be prepared to adapt and evolve how the tool is used and be willing to look ahead because we are just beginning on this AI journey."

Things will continue to change and to improve, so be willing to evaluate critically along the way, she added.

"Successful technology adoption in healthcare is rooted in clinician acceptance but must be built upon the core truth of patient safety," she said. "Blending these two core principles is a win for everyone involved. Physicians are more willing to adopt a clinical AI tool whose parent company ethically deploys its product focusing on accuracy and transparency standards alongside easing burdens of practice.

"When editing their documentation, physicians have said they want 'explainability' in AI, and they want to be able to trust that the tool is accurately reflecting medical standards when it makes suggestions," she concluded. 

"Fighting physician and other healthcare provider burnout by alleviating administrative burdens, while simultaneously meeting the demands of patient safety, are the two areas health systems should prioritize when evaluating AI-based tools in the clinical environment."

Providence is one of the largest Catholic health systems in the U.S., operating a network of hospitals, clinics and physician groups across seven states, including California, Washington, Oregon, Alaska, Montana, New Mexico and Texas.

Its network includes thousands of employed and affiliated providers with an emphasis on delivering coordinated, value-based care. In California, its delivery network represents 17 hospitals and more than 200 clinics.

THE CHALLENGE

Providence in California faced significant challenges within its value-based care contracts, primarily because of manual data processing. It received patient care gap lists from multiple health plans, each requiring the health system to close care gaps through various means such as screenings, lab tests and visits.

While many care gaps were successfully closed, the absence of essential data to health plans forced the Providence team into time-consuming chart mining and to remove barriers to efficient data sharing. The varying formats accepted by health plans added another layer of complexity, requiring Providence to adhere to different data-sharing methods to demonstrate patient compliance across different metrics.

"The administrative burden of managing numerous patient lists from various health plans, regions and lines of business severely complicated performance monitoring and thwarted real-time patient outreach efforts," said Michelle Best, executive director of quality improvement at Providence.

"It was hard to keep track of where you were within each health plan's performance, and we needed multiple people to manage this information to be successful. These patient lists also came in many different formats and would often be sent to the offices directly. Our quality team spent considerable time centralizing these lists to support our physicians and facilitate patient outreach."

Operational staff at the point of care lacked necessary real-time information, resulting in missed opportunities and lower compliance rates. One of the key challenges was that the EHR system couldn't integrate with any tool that would have alerted that a care gap needed to be closed.

Providence invested heavily in patient outreach and follow-up to close open care gaps – particularly through phone calls, which were the most effective but also the most expensive method. If patients weren't caught during a visit, they had to be reached afterward. This created a major operational burden for the teams, who had to rely on labor-intensive outreach strategies to ensure compliance.

"Moreover, we faced persistent challenges in developing dashboards and scorecards due to a lack of raw data, resulting in laborious manual tracking," Best explained. "Although meeting with health plans often required data reconciliation, our previous program in use accepted the best rates from both data sets, reducing the need for alignment.

"This challenge of not aligning with health plans created a barrier to how we were showing performance and what the health plans would report," she continued. "There were additional struggles with delayed claim data and tracking so when we outreached to patients, there was a lot of waste in money, time and resources to patients who had already closed their gaps."

PROPOSAL

The proposed risk and quality reporting technology aimed to enhance California Providence's value-based care contracts by organizing the different lines of business within the organizational hierarchy. This was to provide visibility into contract performance, supplying raw data for dashboards and scorecards, and facilitating data reconciliation with health plans amid a shifting contract landscape.

"This technology promised to automate processes and reduce our manual workload," Best said. "It would allow for real-time reconciliation of health plan care gap reports, offering accurate insights into patients' care needs. The technology could ingest external data, such as claims, registry and EHR data, to automate care gap closures.

"As the contract landscape evolved, the tool would improve accountability between health plans and provider organizations, embedding point-of-care capabilities into operational workflows," she added.

The tool, from vendor Cozeva, is designed to help health systems close care gaps at the point of care and reduce some of the patient outreach efforts on the back end.

"By integrating scheduling files weekly, our teams could identify care gaps before and during patient visits," Best explained. "With standing orders and protocols, the tool would mitigate past challenges by ensuring operational staff addressed care gaps during office visits. The claim and encounter data capturing the closure of care gaps would feed into this tool on a weekly basis, providing visibility into our contract performance across multiple contracts and lines of business.

"It would also help reduce the manual workload of data entry by incorporating different types of supplemental data," she continued. "Additionally, it would assist in reconciling health plan care gap reports because we would have more real-time data to compare their lists to. Having the raw data for reporting would enable us to stay on top of open care gaps and develop strategies to close them sooner. Altogether, this would help improve contract performance."

MEETING THE CHALLENGE

When issuing its request for proposal, Providence sought a tool to efficiently manage the growing number of contracts. The tool needed to display accountability metrics and compliance rates, and drill down to multiple hierarchy levels, including the patient level.

"It needed to go deep and wide, as we have patients and contracts across California," Best noted. "It required real-time capabilities to assist operational teams with accurate patient outreach, integrating both standard and non-standard supplemental data for closing care gaps with a two-step approval process.

"Cozeva's platform enabled the management of care gap reports from health plans, demonstrating closed gaps and sharing data in an acceptable format," she continued. "Having this type of technology allowed us to perform better each year in our contracts and eliminated many of the challenges we were currently facing."

Providence's approach to quality improvement emphasizes minimizing provider workload while using workflows for medical assistants, advanced practice clinicians, quality team members, pharmacists and many others to help close care gaps without solely relying on providers.

"Our affiliated network providers use this tool more frequently than medical group providers, leveraging it for point-of-care insights to identify patients' needs before and during visits," Best reported. "Our teams focus on health equity using a geo-mapping feature to identify patients in certain areas who need specific interventions to provide culturally competent care.

"This technology is integrated within the medical group Epic EHR, and the tool has an 'overlay feature' compatible with various EHR systems across California that we use for our affiliated network providers," she continued. "Streamlining processes and reducing manual work have allowed us to expand VBC contracts, building on a solid foundation for success."

RESULTS

From 2016 to 2024, Providence successfully increased from one to more than 50 value-based care quality contracts, growing its covered population from 100,000 to more than 650,000 patients.

"These gains have been matched by performance: More than 50 quality awards in 2024 alone," Best reported. "We continue to add more providers to our network and have been able to expand from primary care providers to include our APCs and specialists.

"We have increased our lines of business scope to now include commercial and senior HMO and PPO lines of business, as well as senior PPO, Medi-Cal and Medicare Shared Savings Program patients, and manage all types of quality contracts from ACOs, shared risk to full risk, quality gates, and quality multipliers," she added.

The implementation of a tool that efficiently organizes patients, metrics and data has made managing the success of these contracts feasible, she continued.

"We have experienced a significant increase in quality awards, growing from 15 awards in 2016 to more than 50 by 2019, and maintaining more than 50 awards in 2024," she said. "These awards reflect our tangible quality performance outcomes and the positive impact on patient lives."

Some of the awards included: excellence in healthcare; top ten percent performance in patient experience and top ten percent performance in cost in our AMP CA Quality program; type 2 diabetes gold recognition and BP silver recognition from the American Heart Association; and ELITE status in America's Physician Groups' 2024 Standards of Excellence Survey.

"Recently, we were acknowledged by a health plan as their top provider organization for Medicare Advantage and continue to be recognized as industry leaders across various health plans," she said.

Cozeva's technology enables Providence to concentrate on various disease states, cancer screenings, immunizations and medication management for at-risk patients, facilitating care gap closure through targeted outreach and interventions.

"We have effectively addressed the needs of our poor and vulnerable patients, including our BIPOC population with uncontrolled hypertension, improving compliance and closing disparity gaps these past few years," Best reported. "We continue to close the disparity gaps for this population and increase our compliance rates year over year.

"It also allows us to identify populations of patients who may have language barriers, transportation issues or food insecurities as our community health workers focus on social determinants of health screenings," she continued.

The health system has continued to use different technologies that Cozeva has developed and most recently started using the platform's natural language processing tool.

"In 2022, we processed more than 18,000 outside service entries using the NLP tool, which approved 46% of these entries, saving more than 450 manual hours in the first year," she noted. "By 2024, we maintained 18,000 entries with the tool approving 48%, saving 475 manual hours. As we continue to work closely with our vendor, it's these types of technologies that are put in place to help reduce the manual workload we continue to face while continuing to improve care quality."

ADVICE FOR OTHERS

Regarding the value of a risk and quality reporting tool and related technologies, Best emphasizes to her peers that such a tool is essential for successful and proactive management of VBC contracts.

"You need a tool that is going to help you manage and organize the many facets of your VBC quality contracts and help you drive to success," Best advised. "A great tool will centralize all types of data to help you make decisions around cost, quality, risk and patient experience.

"It can help to monitor patients through the continuum of care and keep data in one central location that is especially helpful when you are having to manage data with affiliated providers that are all in disparate EHR systems," she continued. "This kind of technology also helps to facilitate care coordination across the continuum by integrating various data types from different sources, creating a single source of truth."

These types of tools are needed to reduce the hours spent on setup, monitoring, outreach and performance of contracts, she added. Such platforms are disease registry and management tools, which offer much-needed support to close patient care gaps, track performance and share this data seamlessly with health plans, she concluded.

Follow Bill's HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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