Cleveland Clinic is exploring the use of artificial intelligence in patient-caregiver interactions as buzz around the technology continues to grow in healthcare.
AI was one of the topics Cleveland Clinic CEO and president Dr. Tom Mihaljevic discussed during this year’s State of the Clinic Address, which is given annually by the CEO to the Clinic’s 81,000 caregivers.
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The Clinic is piloting an AI scribe powered by computer software company Nuance that will capture conversations between a patient and a provider and summarize them in a digital medical note. Providers will then be able to review the summary before placing it in the patient’s electronic medical record.
"That will allow for a much more meaningful interaction between a patient and a provider,” Dr. Mihaljevic said in a recent interview with reporters ahead of his annual address. “It will take up to one-third of the time that’s currently being spent entering and typing and retrieving data and will give that time back to providers to really take care of the patients.”
The health system is also piloting an AI interface that will answer questions for patients rather than a provider. In particular, it will focus on patients with chronic diseases.
Mihaljevic said the Clinic has already started testing the AI companion with a certain segment of patients. In blind surveys, patients have often said they found the AI-generated responses more compassionate, detailed and timely than those written by caregivers, Mihaljevic said.
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AI is being used by the Clinic as a business tool as well. The system has partnered with software company Palantir to create a “digital twin” of the system’s main campus and is using AI to predict the number of surgeries performed and patients entering the hospital to determine the best ways to utilize staff and physical resources.
At this stage, the Clinic is being very careful about bringing clinical applications of AI into practice, Mihaljevic said, and there is always a person monitoring AI’s output. Still, the Clinic is “very optimistic” about the future of AI in healthcare.
Here are a few other takeaways from the address and Dr. Mihaljevic's interview with reporters.
Dr. Tomislav Mihaljevic, CEO and president of Cleveland Clinic.
The Clinic generated more than $14 billion in revenue last year. It resulted in an operating margin of 0.4%, which is an increase from 2022. Still, the system has not been immune to the financial challenges plaguing U.S. hospitals.
Mihaljevic said margins are “severely compressed” as a result of the rising costs of wages, supplies and pharmaceuticals, and inflation has outpaced increases in reimbursement.
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Year-over-year, the Clinic saw a 10% increase in labor costs and a 20% increase in the price of pharmaceuticals while reimbursements from the Centers for Medicare and Medicaid Services, the Clinic’s largest payer, grew by only 2.5%, Mihaljevic said.
Despite the financial difficulties of the times, the health system has seen increase in patient encounters, Mihaljevic said, and services to patients have increased by 53% since 2018.
Workforce shortages are a lingering problem that will continue to affect health systems in the coming years, Mihaljevic said.
Shortages existed before the pandemic, he noted, and the industry will need to adjust to living with them for many more years. The Clinic has been focused on retaining its existing workforce and using technology to redesign healthcare delivery processes in the face of these shortages.
Last year, the health system’s caregivers reported 3,800 incidents of physical or verbal violence. That’s over 1,000 more reports than 2022 (2,761). Mihaljevic called violence against caregivers a “silent epidemic.
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The Clinic has continued to enhance its police and security presence, he said, and has installed in every emergency department. It confiscated 30,000 weapons brought in by patients and visitors in 2023.
Continuing with the theme of technology, Mihaljevic said telehealth is now a well-established part of the Clinic’s offerings. More than 10% of visits take place remotely, he said.
As an example, every room at Cleveland Clinic Mentor Hospital, which opened to patients last summer, is equipped so patients can interact with caregivers virtually. Telehealth allows patients to gain quicker access to specialized healthcare services, he said.
This story first appeared in Crain's Cleveland Business.
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