In Alaska, where access to specialist care is challenging and emergency transfers can be harrowing, providers are using AI to speed up diagnosis and improve treatment
Healthcare access and treatment issues in rural and remote areas can mean the difference between life and death for people suffering a stroke. Every delayed minute of care costs roughly 2 million brain cells.
That’s why a consortium of healthcare providers in Alaska is investing in AI to improve the diagnosis and treatment of strokes, which kill about 140,000 people a year.
“There's a lot of time that gets lost and a lot of time that is essentially burned unnecessarily because the standard way that we're used to doing things in medicine is very linear,” says Lucy He, MD, FAANS, a neurosurgeon with Anchorage Neurosurgical Associates and physician sponsor of the Alaska Stroke Coalition, a non-profit established in 2023 to boost care coordination and outcomes in the nation’s most rural state.
In late 2024, the coalition partnered with digital health company RapidAI to launch the Rapid AK Project, a three-year initiative aimed at integrating AI technology at six of the state’s largest hospitals (four other hospitals already have the technology installed). On this platform, specialists at these hospitals can more quickly analyze data sent in by rural providers on stroke victims, improving a care process that saves lives.
Lucy He, MD, FAANS, a neurosurgeon with Anchorage Neurological Associates and physician sponsor of the Alaska Stroke Coalition. Photo courtesy Anchorage Neurological Associates.
According to He, when someone in a remote part of Alaska—about 97% of the state qualifies as remote—suffers a stroke, care providers send CT images to the nearest hospital with stroke diagnosis and treatment capabilities. That process of sending roughly 1,500 images takes about 45 minutes. Specialists then review the images to determine whether the patient needs to be transferred to the hospital for treatment, which usually involves the administering of tissue plasminogen activator (tPA).
In Alaska, that transfer may involve an ambulance, helicopter, and/or fixed-wing aircraft and take hours. Flight crews have 30 minutes to accept the transfer and another 30 to file a flight plan and receive clearance to fly. And after the patient is transported to the hospital, another round of CT images is taken to make sure the patient is still a good candidate for treatment.
Throughout this lengthy process, the patient’s health is declining, reducing the chances that tPA can halt the effects of the stroke and preserve brain function. In some cases, a patient who initially could be saved with tPA might not be saved by the time he or she reaches the hospital.
AI can improve that process, He says, by enabling CT scans to be sent in real time and helping specialists review the images.
“All of a sudden you’ve got an hour that’s been saved,” she points out.
Through the RapidAI platform, she says, care providers and specialists can collaborate and share data more quickly and effectively, analyzing a patient’s chances of recovery and giving everyone – care teams, specialists, transport teams and the patient’s family – a more accurate time frame.
“There's nothing worse than transferring a patient … and then they get here and it's like, no, they're not going to be a candidate,” He says. “Now this patient is far from their family [and] their family still has to fly on their own money down to Anchorage. So it's really about identifying the right patients in a timely manner to make a decision whether it's transfer or stay.”
From Hours Down to Minutes
According to Jeremy Hunter, CMO and CMIO of the Alaska Native Tribal Health Consortium (ANTHC), one of the participating healthcare networks in the Alaska Stroke Coalition, the coalition sees roughly 150 stroke activations a year. Since joining the project, the amount of time needed to assess and begin treatment has dropped from about four hours to roughly 45 minutes.
Those are telling numbers for a population that can be hundreds of miles from the nearest hospital.
“Without a road system, without reliable connectivity in some places, some without running water in villages, it's fascinating delivering care up here,” he says.
Hunter says the AI platform gives local providers more confidence in assessing patients. He can use an app to more quickly share data with specialists. An AI interpretation of a scan, he says, can give emergency care providers some vital information on the severity of a stroke within minutes.
“With stroke medicine, I think it's definitely improving morbidity,” he says. “Even if there isn't an absolute mortality reduction, it's going to be hard to argue that we are not lowering morbidity significantly.”
Using innovative technology to improve stroke assessment and care isn’t exactly new. Health systems and hospitals across the country, from Chicago to Mississippi, have been using telemedicine and digital health tools for years to improve the process, establishing telestroke networks that connect rural care teams with specialists, even using specially equipped EMS vehicles in large cities to improve emergency diagnosis and care.
But while those advances get patients in front of specialists more quickly, AI tools are helping providers see the data they need to see to make critical decisions.
He says AI can drastically reduce the maddening gaps that affect stroke care, improving the chances that a patient will survive and reducing brain damage caused by those delays. He says AI can help providers understand how much of a patient’s brain has been affected by stroke and what can be saved through intervention. This includes a better understanding of whether a patient can be saved by intervention—a literal pain point when a provider has to decide whether to set up an expensive and stressful emergency transfer for a patient in the throes of a stroke.
An Ongoing Path to Better Care
But the technology also gives providers more data, enabling them to understand what causes a stroke and how different treatments work. This can fuel stroke prevention education and resources as well as fine-tuning stroke treatment protocols.
“Really, prevention ultimately is what needs to happen,” she says.
And then there’s cost. Healthcare organizations have little resources to spare on new tech, hence the formation of the coalition and the three-year grant to keep it going. Both Hunter and He say there’s an ongoing effort to sustain this partnership.
“We'll have financial conversations, but I think it is such a vital tool for improving stroke care that unless it's an astronomical number that we just simply can't afford, I don't see how we can go back to not having it,” Hunter says.
He agrees, saying the ROI for this technology should be measured not only in lives saved and emergency transport and ER costs justified, but in education and other resources that help people reduce their stroke risk and providers understand preventive care, diagnosis and treatment.
CNOs and other nurse leaders should be aware of these two pieces of legislation.
So far, 2025 has been a year of chaos for healthcare.
The future of the industry seems uncertain, with large clinical staff strikes and a federal administration that pushes new executive orders on a daily basis.
Now more than ever, it's critical that CNOs and other nurse leaders get involved and advocate for nursing policy. Recently, two bills have come to the forefront: the PRECEPT Nurses Act, and the I CAN Act.
The PRECEPT Nurses Act
The Providing Real-World Education and Clinical Experience by Precepting Tomorrow’s (PRECEPT) Nurses Act is a bipartisan bill introduced by Congresswoman Jen Kiggans (VA-02), and it seeks to provide a $2,000 tax credit for nurses who serve as clinical preceptors to nursing students, according to a press release. The goal is to address the nursing shortage by increasing the amount of nursing students who can complete their clinical training under nurse preceptors.
“Mentors are the backbone of nurturing talent and shaping the workforce of tomorrow, and in nursing, preceptors fulfill this essential role,” said Jennifer Mensik Kennedy, president of the American Nurses Association, in the press release. “The PRECEPT Nurses Act is an important step in recognizing the invaluable contributions of nurse preceptors and ensuring they have the support needed to address critical workforce shortages, particularly in underserved areas.
The I CAN Act
The Improving Care and Access to Nurses (I CAN) Act is another bipartisan bill that would remove the federal barriers in Medicare and Medicaid programs that stop APRNs from practicing to the full extent of their clinical education and training, according to another press release. Representatives Dave Joyce (OH-14), Suzanne Bonamici (OR-01), Jen Kiggans (VA-02), and Lauren Underwood (IL-14) and Senators Jeff Merkley (D-OR) and Cynthia Lummis (R-WY) introduced the bill with the goal of increasing patient access to healthcare while lowering costs and improving quality.
“The reintroduction of this bill is a critical step toward expanding health care access across the country," Mensik Kennedy said in the press release. "By removing outdated barriers, it empowers APRNs to provide the care they are trained for—especially in rural and underserved communities where they are often the primary providers."
Here is what CNOs need to know about these two bills.
A continuing resolution now before Congress would extend pandemic-era telehealth and Hospital at Home waivers for six months.
The up-and-down battle over Medicare telehealth and Hospital at Home waivers is on the upswing again, as a proposed bill to fund the government through September includes extensions for both.
But in typical good news-bad news fashion, those proposed extensions would only run to September, leaving health systems and hospitals wondering whether to keep those programs going or shut them down.
According to the American Telemedicine Association (ATA) and several others, the proposed Continuing Resolution unveiled on March 8 keeps in place pandemic-era waivers on key telehealth coverage and the Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care at Home (AHCAH) program through September 30. Advocates say this would give Congress more time to negotiate a long-term deal, such as a five-year extension supported by the ATA and others.
“We appreciate Congress taking action to prevent a lapse in these vital telehealth flexibilities,” Kyle Zebley, Executive Director of ATA Action, the ATA’s lobbying arm, said in a press release. “While we would have preferred a longer extension, this step ensures uninterrupted access to telehealth services for patients and clinicians, as we continue working toward permanent solutions that reflect the needs of modern healthcare.”
But “uninterrupted access” is a bit of a misnomer. Many health systems and hospitals are relying on the waivers and using Medicare reimbursements to keep these programs going, and the constant battle over extensions is forcing executives to rethink their long-term strategies. Some have already rolled up certain telehealth programs, while others are delaying or cancelling plans to expand their virtual care platforms, figuring the money being put into those services could be best used elsewhere.
As with the stopgap funding bill passed by Congress last December, the new proposed bill would extend to September 30 the following telehealth flexibilities:
Waiving geographic restrictions on telehealth coverage and use;
Expanding the list of providers able to bill Medicare for telehealth services;
Allowing audio-only telehealth services;
Easing originating site restrictions on telehealth so that the patient can receive treatment at home;
Waiving the in-person requirement for telemental health treatment;
Enabling telehealth service for hospice care; and
Enabling Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to use telehealth.
In addition, the bill would extend the CMS waiver for its AHCAH program, enabling the more than 350 health systems following the CMS model to receive Medicare reimbursement.
And like the December bill, several telehealth flexibilities supported by the advocates didn’t make the cut. They include:
First dollar coverage of High Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs);
Support for virtual care providers in the Medicare Diabetes Prevention Program;
Improved coverage for digital health in home-based cardiology and pulmonary rehab programs; and
The SPEAK Act (HR 6033), which paves the way for accessible telehealth services.
The ATA’s Zebley said the inclusion of the telehealth and Hospital at Home extensions indicate that Congress “has listened” to the intense lobbying effort by the organization and others. But he also acknowledged that “the path forward remains uncertain.” There’s no guarantee that Congress will approve a final bill that includes those provisions.
Preventing workplace violence takes a collaborative effort, says this CNO.
On this episode of HL Shorts, we hear from Linsey Paul, CNO for the Mercy Health Lima Market, about how CNOs can strategize to prevent workplace violence. Tune in to hear her insights.
Being a preceptor is more than teaching someone the tasks of the job, says this nurse educator.
Editor's note:Emily Berta, DNP, MSN, RN, is a nursing educator and professional development leader, serving as Director of Professional Development and Education at a community hospital and an Adjunct Assistant Professor at Georgetown University School of Nursing. With a background in critical care, progressive care, and emergency nursing, she is dedicated to advancing nursing education and practice.
In my 23 years as a nurse, I’ve seen how the world of nursing has evolved — sometimes rapidly and, at other times, not quickly enough. One of the most pressing challenges we face is the transition of newly licensed nurses (NLN) into the workforce. These nurses, having entered the profession during or after the chaos of COVID-19, are often arriving with less clinical experience than their predecessors. It’s not their fault, of course. Their education has been shaped by a pandemic that upended traditional models. But now, the responsibility falls to us — nurse leaders and healthcare organizations — to bridge that gap and ensure these NLN’s are supported, prepared and confident as they begin their careers.
This is where preceptor training comes in. Being a preceptor is more than teaching someone the tasks of the job; it’s about mentorship and creating an environment where new nurses can thrive. And yet, all too often, we see NLNs being assigned to precept others. While it might seem practical, this practice can set up both the preceptor and the new nurse for failure. Nurses just six months into their careers are often still finding their footing. Expecting them to guide others not only undermines their own growth but also creates a potentially precarious situation for patients and the entire care team.
Structured programs -- such as Fundamental Skills for Preceptors from the American Association of Critical-Care Nurses (AACN) -- offer a solution to this challenge. These programs provide preceptors with the tools, knowledge and confidence to mentor effectively. They teach the art of preceptorship — focusing not only on clinical skills but also on emotional intelligence, communication and fostering a culture where learning is encouraged. Unlike many hospital-developed training programs that focus on policies and procedures, these programs prioritize best practices and human connection.
I’ve seen the impact of such programs firsthand. I recall one experienced nurse who had always been a go-to for clinical expertise but struggled in her role as a preceptor. Her approach, although well-intentioned, left NLNs feeling devalued and afraid to ask questions — a dangerous dynamic in any clinical setting. After participating in a structured preceptor training program, she gained a new perspective. She started to reflect on how her words and actions affected those she was mentoring. When her preceptees shared their feedback, she listened with humility, acknowledging the need to adjust her approach. The transformation was remarkable. She became a more empathetic mentor, and the unit’s teamwork and morale improved as a result.
These changes benefit more than the nurses involved. They ripple outward, improving retention rates, enhancing patient care and creating a stronger, more resilient workforce. When preceptors are well educated, they empower NLNs to navigate the challenges of the profession with confidence. Those nurses, in turn, are more likely to stay in their roles, provide high-quality care and eventually become preceptors themselves.
In today’s healthcare environment, where nursing turnover is alarmingly high, investing in preceptor education is a smart and necessary strategy. Replacing a nurse can cost tens of thousands of dollars, far outweighing the relatively modest expense of educating preceptors. But beyond the financial argument, this investment speaks to the heart of what nursing is all about: creating a culture of care, support and excellence.
Nurse leaders and healthcare organizations must recognize that structured preceptor training is not a luxury — it’s a cornerstone of sustainable nursing practice. By equipping preceptors with the skills they need to succeed, we ensure that new nurses enter the workforce supported and confident, ready to contribute to their teams and provide the best possible care for their patients. Together, we can build a future where every nurse has the opportunity to thrive.
Editor's note: Care to share your view? HealthLeaders accepts original thought leadership articles from healthcare industry leaders in active executive roles at payer and provider organizations. These may include case studies, research, and guest editorials. We neither accept payment nor offer compensation for contributed content.
Virtual nursing is becoming the standard of care, and nurse leaders must prepare for the next evolution.
In the latest edition of HealthLeaders' The Winning Edge webinar series, a panel of nurse leaders discussed what additional technologies can be integrated into your virtual nursing program, and how to optimize it to best support the bedside nurse and be cost effective.
The discussion included four key takeaways: how to individualize the program for the needs of your health system, get nurses involved, choose the right technology, and make the financial case with ROI metrics.
Tech companies and healthcare providers flocked to Las Vegas this week to talk about the latest innovative tools and strategies. But amid shifting definitions of value, uncertain signals from Washington and increasing pressure to reduce costs and improve outcomes, are healthcare leaders struggling to just stay the course?
The almost frantic pace at HIMSS 25 this week hints at an industry struggling to keep up with the times.
The exhibit hall at the Venetian teemed with people rushing from one event or meeting to the next, making deals or looking to make deals. Technology vendors announced new partnerships, programs and product upgrades at a rate almost bordering on desperation.
Fueled by the advances of AI – in the consumer world as well as healthcare – and digital health, health system and hospital executives are dealing with a rapidly evolving industry. They're being forced to embrace change at a faster rate than they're used to, and in some cases struggling to connect the dots on innovation and ROI. Everybody knows that AI is a transformational tool, and no one wants to be left out.
But healthcare organizations are struggling on several fronts. Everyone is feeling the workforce shortage and looking for ways to keep who they have, attract whoever is out there, or use technology to supplement the workforce. Money is tight, so there's little to spend on new ideas or technology and a strong push to reduce costs and inefficiency.
For Susan Gutjahr, HIT Director for Sparta Community Hospital, the urgency is there to find technology that can help the 25-bed critical access hospital in Sparta, Illinois stay open. The hospital epitomizes the small, rural facility in farming and mining country struggling to keep up with the big boys in Chicago, several hours to the northeast, and St. Louis, 50 miles to the northwest.
"It's hard to find [technology] for us," she says, noting the hospital has had the same EMR since 1997. "We really need to get our foot in the door."
Gutjahr says hospital leadership is eager to find tools to improve patient engagement, an important strategy for small, rural hospitals that are often the linchpin of the community. She says they received federal funding during the pandemic, which they used to boost their virtual platform and reward stressed out staff, but that money is gone now and there's no indication that they'll be getting anything from Washington.
"We need to ask some hard questions about what this [technology] could really bring us," she says.
At the other end of the spectrum is the University of Texas MD Anderson Cancer Center, a well-known health system looking to expand its innovation strategy. Lavonia Thomas, BSN, DNP, MSN, RN, the health system's Chief Nursing Informatics Officer, led a team of nine nurses to HIMSS with the goal of finding the right technology that nurses will actually value and use.
"What are the problems that nurses at MD Anderson have that [can be addressed] here?" she asks. "We want to know what the nurses think. We know that the nurses using [this technology] will determine its return on investment for us."
And that may be the key to HIMSS' sustainability, which took a hit during COVID-19 but seems to be rebounding quite well. The healthcare C-Suite may not be in Las Vegas in big numbers this week, but many have sent executives and, just as importantly, clinicians in their place to get a good look at what's available.
Thomas points out that nurses require different things from new technology than doctors, so they need to check out the tools themselves. An ambient AI tool that's winning rave reviews from doctors for capturing the patient encounter won't address nursing needs.
So while the pressure is on providers to find the technology that works best for them, there's also an increasing amount of pressure on the technology industry to give health system and hospital executives the tools they need.
Srinivas (Sri) Velamoor, President and Chief Operating Officer of NextGen Healthcare, sees an industry in a certain amount of turmoil, looking to keep up with a technology that's being embraced by consumers just as quickly as other industries. The rush to create AI tools that meet the demands of providers is daunting, as are the needs to validate data, monitor on a continual basis, and even share risk with providers.
There's no doubt that AI will transform healthcare, he points out, and some of the larger, more established players in the healthcare technology ecosystem may have to tear themselves down and completely rebuild to meet new demands. Others are changing how they sell their products, especially to not-for-profits, rural hospitals and clinics that have limited resources but need that technology to survive.
So amid all the popcorn, puppies, happy hours and magic tricks on the HIMSS25 show floor this year, there's also a certain amount of desperation. Jump on the bandwagon now or risk being left in the dust. Try out a new tool, forge a new partnership, make a new deal, and look for those KPIs and benchmarks quickly. The clock is ticking.
While health systems might be at different stages of implementation, there are several key virtual nursing strategies that CNOs should take into consideration.
Virtual nursing has spread far and wide throughout health systems across the country as it becomes a critical component of patient care, and it's gaining buy-in from nurse leaders everywhere.
While health systems might have different approaches or be at different stages of implementation, there are several common virtual nursing strategies that CNOs should take into consideration.
The panel discussion included four key points about virtual nursing strategy.
Individualize the program
First and foremost, virtual nursing programs should be individualized to fit the needs of a health system. CNOs can begin this process by identifying the problems that the program will work to address, and narrowing down the specific needs of the nurses, patients, and other staff who will be impacted by the program.
Some common goals for virtual nursing include reducing time spent completing administrative tasks such as admissions and discharges, and giving time back to bedside nurses. During a time when nursing shortages are growing, and patient acuity is greater, it's essential that unnecessary tasks and high workload burdens be removed from nurses so they can spend their time caring for patients.
Virtual nursing can offer an avenue for nurses who want to retire or who can't work at the bedside anymore to continue sharing their knowledge and participating in care delivery. Those nurses can then mentor novice nurses as well.
Get nurses involved
The first half of the equation with virtual nursing is the nursing workforce, and getting nurse buy-in is essential. While there might be caution surrounding virtual nursing and its implications, it's up to the CNO to show the positive benefits on both staffing and patients and to bring the nurses into the conversation.
Nurses are well equipped to give the best feedback about workflows and input on what they need to make their jobs easier. Nurses can also help get the word out quickly about new programs, which can greatly help with program adoption, and they can help with testing and troubleshooting. It's important that CNOs listen to the needs of the nurses and work with them to implement the best solutions.
Choose the right technology
The second half of the equation is the virtual nursing technology itself. Determining the right technology for a virtual nursing program begins with having a strong partnership with IT departments and innovation leaders. That partnership creates a strong feedback loop where nurses can help the IT project managers understand what needs to be done, and the IT department can work towards achieving those goals. CNOs should also lean heavily on their CNIOs, since they are able to blend nursing and technology together to come up with the best outcomes.
When selecting what technology to use, CNOs should pilot different technologies and give themselves plenty of time to test things with the understanding that it might not work the first time. The beginning stage of any virtual nursing program offers tremendous learning opportunities. Choosing between carts or fixed, in-room technology will depend heavily on the needs of the department, the nursing unit, and the patients and staff involved.
Make the case
Lastly, CNOs must be able to make a financial case for virtual nursing. This can be difficult because many virtual nursing ROI metrics are considered "soft" metrics, that save "soft dollars." However, there are several concrete metrics that CNOs can look at for positive outcomes, such as reduced admission and discharge times, and better recruitment and retention numbers. Improving discharge information and discharge planning can help reduce readmissions as well.
Other metrics can include nurse engagement, patient experience, and care quality metrics. Patient outcome metrics, such as fall prevention, can also be impacted by virtual nursing, especially with the incorporation of additional technologies. Improving patient outcomes helps reduce costs from negative outcomes.
Announced at HIMSS25, the partnership between the New York health system and Amazon enables patients to confirm their identity in seconds.
NYU Langone Health is launching a new biometric technology platform that’s designed to enable patient registrations through a palm scan.
Announced during the first day of the HIMSS25 conference and exhibition in Las Vegas, the New York health system is partnering with Amazon to launch the Amazon One tool through the Epic EHR platform. The technology enables patients to confirm their identity through a palm scan, which is reportedly more than 99% accurate, less intrusive than other forms of identity verification, and takes place in seconds.
"One of NYU Langone’s goals is to leverage cutting-edge technology to enhance the patient experience,” Nader Mherabi, EVP, Vice Dean and Chief Digital and Information Officer at NYU Langone, said in a press release. “We make all decisions with our patients in mind first and foremost, and we’re always looking for ways to improve their experience through technology. As with all new initiatives and technology of this scale, we will optimize over time and meet the needs of our patients.”
As HIMSS kicks into gear this week, announcements like this are indicative of an industry striving to use innovative technology to improve the patient experience. Health systems and hospitals are under pressure to not only improve clinical outcomes and cut costs, but also make the patient’s care journey more intuitive.
The registration process is a key pain point in healthcare, and health system leaders are looking for ways to reduce the questionnaires and paperwork that make the process longer and more cumbersome, thereby reducing the time a patient can actually spend with their care team.
The partnership takes advantage of a technology now being used in airports, sports stadiums, convenience stores and fitness centers, and marks Amazon One’s largest third-party healthcare deployment to date. It’s also an example of the healthcare industry looking to other industries for innovative ways to solve nagging problems.
According to executives, the Amazon One platform accesses the EHR only to confirm the patient’s identity, and does not access or store any other patient data. Patients are asked to create an Amazon One profile ahead of their visit and link that profile to NYU Langone.
NYU Langone expects to roll out the technology to all locations within the year.
