Tommy Ibrahim, the health system's new (and first ever) Chief Transformation Officer, says new models of care will set the stage for true value and growth.
To Tommy Ibrahim, healthcare needs to evolve to meet the needs of America's rural populations. The time-honored practice of going to the doctor's office or hospital for care doesn't work when those sites are either closed or hundreds of miles distant.
"We need to change how we think of healthcare," he says.
Tommy Ibrahim, MD, MBA, MHA, EVP and Chief Transformation Officer at Sanford Health. Photo courtesy Sanford Health.
Ibrahim, MD, MBA, MHA, was recently named the first-ever Chief Transformation Officer for Sanford Health, the nation's largest rural health system. He steps into the position with a wealth of experience, having served as president and CEO of the Sanford Health Plan for two years and, before that, spending almost four years as president and CEO of Bassett Healthcare in upstate New York and about three years as CMO and then Chief Physician Executive at Oklahoma's INTEGRIS Health.
[Listen to the HealthLeaders podcast: How Digital Health Can Help a Rural Health System, With Bassett Healthcare CEO Tommy Ibrahim.]
The challenge, Ibrahim says, begins with understanding how care can and should be delivered to more than 2 million people across several states.
"We are a rural healthcare organization," he points out. "99% of the 320,000 square miles that we serve are rural. So we are challenged with [serving] disseminated communities. We face challenges with nurse recruitment. We face challenges with physician recruitment. And our population is different. They're very unique in that they have different social determinants of health. They have different medical needs and chronic disease burdens. And we need to be sure that we are implementing solutions that we actually meet those needs."
Innovation Through the Virtual Care Center
To understand how to meet those needs, Ibrahim points to digital health and virtual care programs developed and launched through the Virtual Care Center, an innovation space unveiled in 2024. He notes Sanford has invested more than $350 million in programs and platforms that have pushed care out of its hospitals and into communities, offering access to 78 specialties across 93 locations.
Sanford's telemedicine platform is a literal lifeline for patients, two-thirds of which live more than 30 miles from the nearest major medical center. Officials say the average virtual care visit saves a patient 176 miles, and the health system has helped save more than 58 million miles of travel over the past decade.
Alongside virtual care, Ibrahim says the center includes simulation rooms for testing AR and VR programs, a model hospital room of the future, and space set aside for anyone from the health system who has an idea or tool to test.
Perhaps more importantly, he says Sanford Health also wants to test new and unique payment models.
"We have a great opportunity here to define value-based care," he says.
A Plan for AI
And then there's AI.
Ibrahim says the health system is building a three- to five-year AI strategy, and emphasizing high-value, high ROI uses first. The technology has already proven itself in revenue cycle management, where it has saved tens of thousands of hours in administrative tasks and freed up staff to concentrate on other areas of improvement.
He also says the health system is open to developing its own AI tools.
"I think long-term we'll probably have a mix" of tools developed in-house and purchased through vendors, he says. "This area is moving so fast. I don't think we have the resources to meet the demand. But there are certain things that we can do and that we have done incredibly well and have already deployed with success. And there are other things that we're going to have to lean on the industry."
More than 20 machine learning algorithms have already been developed by Sanford, he says, many of them focused on early identification of chronic conditions. One screening tool, integrated in the EHR, analyzes 85 different factors for colorectal cancer to identify patients who might need a colonoscopy sooner. The tool gives clinicians a risk score that can help guide their treatment recommendations, and has been especially helpful in the Dakotas, where a lack of GI specialists intersects with a high colon cancer rate.
Another tool, also embedded in the EHR, flags patients at risk of chronic kidney disease (CKD), often well before any symptoms appear. According to officials, CKD testing among patients living with diabetes doubled just 10 months after the tool was deployed, and CKD diagnoses more than tripled, giving clinicians more time to develop long-term and effective treatment plans to prevent or delay kidney failure and dialysis.
Ibrahim says the wins need to be tempered by a commitment to governance.
"These tools need to be deployed responsibly and safely," he says. "We need to make sure that they're implemented in a manner that is consistent with the standard of care that we want to deliver. And then, we have to have mechanisms in place [so] that we're constantly monitoring and auditing for the outcomes that we're looking for."
"I think safety is first and foremost the priority," he adds, "that you know these models are actually enabling us to take better care of patients and not sort of [create adverse outcomes]."
Eric Wicklund is the Associate Content Manager and Senior Editor for Innovation and Technology at HealthLeaders.
KEY TAKEAWAYS
Sanford Health's virtual care platform is helping the rural health system reach out to its patients rather than having them drive to the hospital.
New care models have to be flexible enough to meet the needs of a rural community and precise enough to give patients what they want.
AI will help healthcare organizations improve chronic care management by helping clinicians identify health concerns earlier, allowing them to create effective care management plans.