A health system-backed venture that looks to centralize digital health apps could hone artificial intelligence's use in the healthcare industry, Intermountain Health president and CEO Rob Allen said.
Salt Lake City-based Intermountain, Albuquerque, New Mexico-based Presbyterian Healthcare Services and St. Louis-based SSM Health in 2021 launched Graphite Health, described as a central repository of digital health apps and healthcare data.The marketplace looks to support a "plug-and-play" model for digital health, in which hospitals can deploy vetted digital health tools without spending significant time reconfiguring them, the organizations said.
Allen, who replaced interim president and CEO Lydia Jumonville last December following the merger between Intermountain and Broomfield, Colorado-based SCL Health, in an interview talked about Graphite's role in the use of AI in healthcare, telehealth, the hospital-backed generic drug company Civica, rural health and other topics. The interview was edited for length and clarity.
How is Graphite progressing?
Graphite has the opportunity to be the grounding point for [artificial intelligence]. Graphite can become a platform where all these evidence-based best practices could be brought into this data set and have the AI check it. Graphite can help us use databases that systems like ours, Mayo Clinic and others have created to create a national checkpoint, so everybody can benefit from that protocol. At the same time, AI can use its capabilities to support clinicians by curating medical knowledge. Graphite could look at the patient record, and the doctor can start querying information about what they are looking to do. Now, doctors are spending time exploring options for a patient based on their personal needs. The risk is, as we’ve seen in some of early trials of ChatGPT, is that it can create its own answers and argue it’s right. So, what are the checkpoints against it? How does the doctor know that they're getting real information? I think it is one of the keys to personalized medicine, as long as you have the right guardrails.
How are you using technology to simplify caregivers’ jobs?
One of the things we are trying to do is use ambient dictation for doctors. The doctor will pull out their phone, set it on the counter and have their visit with the patient. It listens to it, dictates it all and does the charting for them. Doctors are reporting saving two hours per day, which is life-changing for them. We’re also focusing on education and development. We have the Peak Program, where we give our caregivers up to $5,250 a year to use in any way they want for personal development and advancement. And if they don't use it, they can gift it to a family member. Another thing we’re doing is piloting nursing tools. We’re using telehealth-capable cameras in patient rooms so a remote physician can see everything and help treat patients from a remote station. Why don’t we use those to read all the data and do the nurses’ charting? We’re doing a pilot in one of our hospitals, and looking at how you overlay that with a Siri-type function.
What are the results?
Our 2022 nursing vacancy rate [of 8.35%] was about half the [17%] national average. Over the past year, it’s moved to about a third [to 6.55%]. Hopefully, that'll bear a lot of fruit over time as more nurses stay with the system and recruit others.
How are your rural hospitals faring?
Telehealth is a critical part of our strategy. The evolution is simply looking how we can get them more support. Viability is a real challenge in these rural communities. For example, our Fillmore (Utah) Hospital has struggled forever to survive. It delivers about 50 babies a year. It’s a costly service. The reality is, the distance from that hospital to the next is so far, that you’re still going to deliver babies. They’re going to show up in your ER. With our telehealth programs, we are able to provide extenders that allow us to add to [rural hospitals'] capabilities while maintaining service lines. We don’t have any site right now where we are looking to pull services, but rural hospitals are going to have to face some of that. We hope ours don’t.
How’s your hospital-at-home program doing?
It’s going well. As a country, we need to do a lot more of it. We can do a lot more in other sites than in hospitals. We have 31 ambulatory surgery centers in play or in development. We have seven Tellica outpatient imaging centers and are shooting to open 25. We’re routing our value-based patients through there. All those pieces—hospital at home, ASCs, Tellica imagining—are ways to make care more accessible and more affordable.
What’s the latest with Civica?
I was amazed at what happened after Civica announced they were going to make insulin last year. Just after the announcement, [drug manufacturers] dropped the price from over $300 to $100, and it’s still creeping down. It’s those opportunities to impact the market. Another thing Civica does is stockpiling certain inventories of drugs. When we look at all the shortages that keep coming out of the pharmaceutical side, having that kind of an approach helps takes away the ebbs and flows of pricing and the ability to get the drugs.
How’s the integration with SCL Health going?
It’s going well. If it was a construction project, we’d say we’re on time and on budget. We’re on a two-year time frame that goes through next April. The work of moving the system forward never ends, but we will have gone through and completed the process of connecting the systems at every level and within every function.
What are the challenges?
The intent was not just to roll SCL under Intermountain, it was to bring the systems together—so we are rebuilding each area. We are asking, what’s the leadership structure in that area? What is the governance and decision-making process between the system and the regions? What are the systems that support it? The hardest decisions are the people. There’s also blending the IT systems. Intermountain is on Cerner and SCL is on Epic. We just announced that Intermountain is moving to Epic over the next two years. It wasn't [initially] intended, but over time, it became the right decision for us, our doctors and nurses.
What’s your growth outlook?
This will be our focus: How do we build out all the pieces for value-based care in the markets we serve? We’ll do organic growth, like we always have, and look at tuck-in deals, like the ones we’ve done with physician practices, home care and air ambulance services. The big ticket is do you do another merger? We get a lot of phone calls, as you might imagine. We tell most of them no quickly. We will look at structures and opportunities that are accretive to our ability to deliver on our mission.