The healthcare industry is ready to adopt new technology and shift to consumerism but is skeptical of the changes without governance and guardrails.
Digital health leaders at Modern Healthcare’s Digital Health Transformation Summit this week addressed changing consumer expectations, responsible artificial intelligence implementation and the need for boardroom conversations, among other topics.
Here are eight takeaways.
1. Leaders want guardrails around AI.
Health system leaders are excited about generative AI tools like ChatGPT but want to see guardrails established around usage.
“We have to embrace it. It’d be like telling people to use a rotary phone and to not worry about mobile phones,” said Dr. Paul Casey, chief medical officer of Chicago-based Rush University Medical Center. "It’s going to become a part of how we operate."
Casey said generative AI is already in use at Rush, which is developing a framework to guide employees on appropriate use.
It’s not just generative AI that needs oversight. Providers want to establish guardrails for all forms of AI. Desiree Gandrup-Dupre, senior vice president of care delivery technology services at Kaiser Permanente, said the health system is moving cautiously and creating a corporate governance structure to understand the risks associated with the AI models it’s developing.
“We want to make sure there’s an approval process before we go overboard on doing any type of massive deployment,” Gandrup-Dupre said.
2. Investors want a piece of the pie.
Venture capital firms see dollar signs ahead. Daryl Tol, head of health assurance ecosystem at venture capital firm General Catalyst, said AI and interoperability will dominate the digital health conversations in coming years.
General Catalyst was behind a recent $50 million seed investment in Hippocratic AI, a generative AI company focused on healthcare.
"Consumers for a long time have wanted there to be a brain in healthcare that’s always on that’s not the doctor’s brain,” Tol said.
3. Governance is important.
Creating the right governance structure is important to successfully implement digital health solutions. Marty Bonick, president and CEO of Nashville, Tennessee-based Ardent Health Services, said the system created a committee to determine Ardent's critical problems and look at potential solutions. Bonick said he is not part of the committee but uses it for guidance.
“We’re trying to get this out of the corporate office environment and really going out into the front line. We’re talking to our staff … about what are the problems we’re facing,” Bonick said. “They are not necessarily the problems a lot of companies are [developing] solutions for … but if I can solve for throughput efficiency or nurse safety, those will have a lot more of a benefit.”
For any potential solutions that affect medical care at Rush, Casey said an all-clinician work group vets the technologies.
4. Boards are heavily involved.
Mike Roberts, chief technology officer of VillageMD, said the company’s directors play a vital role in helping the organization pick the right digital health solutions.
“Our board doesn’t just bring a healthcare background, but they have financial services and consumer backgrounds as well,” Roberts said. “It’s not just about having the right people on your board with the right connections but having them truly engage in your business. And not just at board meetings. … In between board meetings is what I’ve found the most helpful.”
Bonick said Ardent named Dr. Edmondo Robinson, chief digital officer at Moffitt Cancer Center in Tampa, Florida, to the board in January 2022 so it could tap his digital health competency.
5. Single-point solutions are so not happening.
Health systems are unlikely to adopt single-point tech solutions, which traditionally only address one area of medicine and may not connect with other clinical systems.
Many health systems are going to say no to a solution that doesn’t integrate with the provider organization's electronic health record, according to Dr. David Lubarsky, CEO of UC Davis Health in Sacramento, California.
Health insurers aren't keen on single-point solutions either. Tracy Saula, Highmark Health’s senior vice president of product and health experience, said many digital health companies don’t really understand what Highmark is looking for in technology.
“Those of us who are trying to really drive transformation with the customer in the center, it's going to take this pool of potential vendors and partners in the ecosystem to shrink and shrink [down] to those who get it,” Saula said. “There are a lot that don’t get it. ... They don’t see that they’re part of something bigger.”
6. Consumers could get a bigger role.
Industry newcomers are looking at changing consumer demands as their entry point. Executives at big tech companies like Amazon said their healthcare strategies will revolve around improving the patient experience by relying on customer feedback.
“If you're going to be customer obsessed, that means following the 'yeses' and also understanding what the customer is telling you to adjust, to change," said Dr. Nworah Ayogu, chief medical officer and general manager at Amazon Clinic.
Traditional health systems are sensing the shift but face obstacles, including addressing a workforce shortage, caring for diverse populations and overcoming geographical barriers.
“It’s about having the customer meet us where they want to meet us, but that’s really difficult,” said Bill Bellando, the chief information officer at Marietta, Georgia-based Wellstar Health System. “And it’s continuously changing.”
7. Virtual visits will expand.
Many systems are looking for ways to meet patients where they are through virtual care.
Sioux Falls, South Dakota-based Sanford Health broke ground last year on a virtual care center near its headquarters that will serve as a hub for virtual clinics and telehealth services.
Other health systems are embracing virtual care to increase engagement and better serve patients.
"We don't really need to build any more facilities, any more clinic offices or any more hospital beds,” Lubarsky said. “We just need the right ones, for the right level [of care].”
8. CMS wants to be in the conversation.
The Centers for Medicare and Medicaid Services sees a big opportunity in publishing open-source code and is in the midst of modernizing its systems. Some of its new Java code started to publish online in January 2022.
“A lot of the stuff people are building, we’ve actually already built,” said Andrea Fletcher, executive director of the digital service at CMS. “If we publish a version [of that code] that is standardized and then everyone else can tailor it to their needs ... I think that would put us and everyone else in the space in a better situation.”
Dealing with outdated systems and coding languages is one challenge. Another big one: Many of its developers are nearing retirement age. Fletcher said an aggressive recruiting push is underway and recent layoffs in the private sector could present an opportunity for the agency.
