At its annual user's conference, the EHR giant unveils a strategy that includes hundreds of AI programs and plans to address inpatient monitoring
As healthcare organizations develop AI strategies that use both in-house talent and outside vendors, Epic is reminding the industry that most of those new tools will work best through the EHR.
And they're even better if you're part of the Epic universe.
The nation's largest EHR vendor launched its 45th annual User's Group Meeting (UGM) on Tuesday with an exposition from company founder and CEO Judy Faulkner and several top executives on past successes, current programs—including a glitzy accounting of health systems and hospitals switching over to the Epic platform--and future plans. And with more than 100 AI applications now in use, the company aims to keep the momentum going.
"Healthcare still has tons of problems and … challenges," she announced, and Epic's goal is to "try to make care better."
Epic's pitch to attendees from every state and 16 countries, both at the Verona, Wisconsin campus and online, was two-fold. The company wants to keep its customers in-house, embracing new services and opportunities rather than adding onto the platform from outside sources (what Faulkner called YOYO, or You're On Your Own). In addition, Epic is looking to establish its capabilities as an AI innovator, with hopes of using the technology as a springboard to more growth.
Faulkner spearheaded this strategy by noting Epic has scored early successes with AI in two clinical care programs currently in the spotlight: e-mail inboxes and the doctor-patient encounter.
According to Faulkner, some 186 healthcare organizations are now using Epic's AI Charting tool, which uses ambient technology to capture the conversation, produce a transcript almost immediately and, after clinician review, enter the data into the medical record.
"A click saved is a click earned," she said.
She and other executives said the company plans to enhance this service to include orders, ED notes, inpatient notes and charting for nurses (a feature that Baptist Health, Duke and Intermountain Health are already testing).
In addition, Faulkner said more than 150 healthcare organizations now use In Basket ART (Automated Response Technology), which uses AI to sort through e-mail messages and, in some cases, provide responses. The tool, she said, saves clinicians about 30 seconds per message and, in many cases, offers patients a more empathetic response than one written by a stressed-out doctor or nurse.
"I think that's kind of funny: The machine is more human than the human," she added.
Proposed enhancements on that tool include meeting summaries, message drafts, conversational search and suggestions.
And while the company has more than 100 AI features now inn use, Faulkner and her executives noted many other possibilities for the technology, including bi-directional faxing, routing claims through the EHR without the need of a clearinghouse, personalized patient reminders and recommendations through MyChart, chronic disease management summaries, and billing code recommendations.
Two areas of particular interest are payers and inpatient services. Company executives said Epic will develop AI tools to help providers work with payers on everything from claims to appeals and billing, and will debut a Professional Billing Exchange this fall.
As the inpatient experience, Faulkner and executives said Epic is designing AI tools to help monitor patients and detect or even prevent falls, as well as tools to automatically identify staff when they enter a room, aid in virtual nursing, and help patients with communications and entertainment options.
As with any user's conference, the Epic presentation was meant to update healthcare organizations on the company's progress, but it also underscored the intense competition in the healthcare marketplace for AI. As Senior Vice President Sumit Rana noted, there will come a time when the health system C-Suite has "AI vs. AI" conversations.
"While AI might not be perfect, it is developing rapidly," he noted. "AI is a force multiplier."
Virtual care platforms have many benefits for nurses, patients, and their families, say these healthcare leaders.
Many organizations are turning to virtual nursing to address staffing and wellbeing, and with the current trajectory virtual care will be an integral part of the future of healthcare.
The use of telemedicine following the COVID-19 pandemic kick started the virtual nursing movement. And while some systems are just getting started, many have been utilizing virtual nursing for years and continue to expand.
Researchers at Brigham and Women’s Hospital used AI to help understand when radiation treatments can cause dangerous heart arrhythmias.
Healthcare researchers are now using AI to gain a better understanding of when patients should and should not receive radiation as part of their treatment.
In a study published in JACC: CardioOncology, a team from Brigham and Woman’s Hospital used an AI tool to better understand the risk of cardiac arrhythmia for patients undergoing radiation treatment for lung cancer. The results not only could lead to better treatment plans but also improve care for the estimated 1 in 6 patients who experience severe side effects, including death.
“Radiation exposure to the heart during lung cancer treatment can have very serious and immediate effects on a patient’s cardiovascular health,” Raymond Mak, MD, director of clinical innovation for the Department of Radiation Oncology at Brigham and Women’s and corresponding author for the study, said in a press release. “We are hoping to inform not only oncologists and cardiologists, but also patients receiving radiation treatment, about the risks to the heart when treating lung cancer tumors with radiation.”
The study is just the latest effort by health systems and hospitals to apply AI to clinical care pathways.
This research targets patients receiving radiation therapy to treat non-small cell lung cancer (NSCLC), for which arrhythmias can be a common side effect. Because NSCLC tumors and the treatment to eradicate them occur close to the heart, the heart can be affected by those doses of radiation.
The Brigham and Women’s team used AI to gain a more focused understanding of how the heart is affected by that radiation treatment. Researchers analyzed data from 748 patients who had been treated with radiation for locally advanced NSCLC to identify different types of arrhythmia that can occur. They found that 1 in 6 patients experience at least one grade 3 arrhythmia within roughly two years of treatment, and 1 of every 3 of those patients experienced “major adverse cardiac events.”
“An interesting part of what we did was leverage artificial intelligence algorithms to segment structures like the pulmonary vein and parts of the conduction system to measure the radiation dose exposure in over 700 patients,” Mak said in the press release. “This saved us many months of manual work. So, not only does this work have potential clinical impact, but it also opens the door for using AI in radiation oncology research to streamline discovery and create larger datasets.”
Mak and his team concluded that radiation oncologists should collaborate with cardiology specialists when developing radiation treatment plans, including embracing strategies that “actively sculpt radiation exposure” away from the areas of the heart that are susceptible to arrhythmias.
Nurses need to be healthy so they can take care of patients, says this nurse leader.
On this episode of HL Shorts, we hear from Dr. Shakira Henderson, Dean, Chief Administrative Officer, and Associate Vice President for Nursing Education, Practice and Research at the University of Florida College of Nursing, and System Chief Nurse Executive of UF Health, about how nurse leaders should implement recruiting and retention strategies that address burnout as well as the nursing shortage. Tune in to hear her insights.
PCORI has issued grants totaling more than $27 million to three research projects comparing virtual care to in-person care.
Three healthcare organizations exploring the use of telehealth in care management are getting grants from the Patient-Centered Outcomes Research Institute (PCORI).
The non-profit, which focuses on clinical effectiveness research (CER), announced more than $27 million in grant awards for three projects comparing care delivery via telehealth against traditional care methods.
"At the center of comparative clinical effectiveness research is a recognition that patients’ needs are diverse and not all treatments or interventions have the same effects for everyone,” Harv Feldman, MD, MSCE, PCORI’s deputy executive director for patient-centered research programs, said in a press release. "These CER studies will generate evidence about how different approaches to care may work better for some patients for health concerns facing different people every day."
The three projects are:
Tapan Mehta, PhD, of the University of Alabama at Birmingham, is receiving almost $11.5 million to study how two different telehealth programs—remote patient monitoring (RPM) and digital health coaching—might help with care management for people living with type 2 diabetes who have multiple chronic conditions and physical disabilities. The study will examine each approach individually as well as together.
Stephen Henry, MD, MSc, and Aimee Moulin, MD, MAS, of the University of California, Davis, are receiving $6.4 million to compare treatments for patients living with substance use disorder (SUD). The research will compare outcomes for patients who start buprenorphine treatment in the emergency department and transition to an outpatient program by telehealth as compared to those undergoing in-person treatment.
Richard Skolansky, DSC, and Kevin McLaughlin, PT, DPT, of Johns Hopkins University, are receiving almost $9.6 million to study the effectiveness of a telerehabilitation program for people living with chronic low back pain against in-clinic treatment.
The grant awards are part of a larger group of 10 awards totaling $165 million for CER research projects. Since 2010, the organizations has awarded more than $4.5 billion in grants for CER research.
Nurse leaders should follow these steps to determine what staffing model works best for both patients and nurses, says this CNO.
When implementing new staffing models, there are several factors to consider. CNOs must prioritize what works best for patients while also meeting the needs of their nurses.
According to Vicky Tilton, vice president of patient care services and chief nursing officer at Valley Children's Healthcare, there are four steps that CNOs should take to determine what staffing model works best for their health system.
HealthLeaders CEO editor Jay Asser is joined by Kat Kemper-Kelly, senior consultant with Vizient security management, to discuss key strategies to help health systems improve safety and security, including cultural buy-in and integration of technology.
New York’s largest health system has launched a production company that is developing scripted and unscripted media content, including documentaries and docudramas. The intent, says Ramon Soto, Northwell’s SVP and chief marketing and communications officer, isn’t to make money or discover the next George Clooney, but to market the brand and give the health system an avenue to produce issues-driven content.
“Northwell wants to just show up differently to consumers, and we compete in a hyper competitive market,” he says. “So when we show up, how do we get a consumer to take notice of Northwell and to choose us … particularly when you have great choices?”
Soto says the strategy encompasses two main goals.
“One, we can invite consumers in and see all the things that happen behind the glass that they never get exposure to,” he says. “And it’s wonderful content. There’s a reason why Grey’s Anatomy is super successful. You show the power of health and how it fuels your life, your love, your passions, your careers, [with] really deep human interest stories.”
“The second part is we found a lot of value in telling stories about socially important topics that society has to have more conversations around,” he adds. “And sadly, there are too many of these.”
The idea for Northwell Studios—and Soto is quick to point out this isn’t a movie studio out in Hollywood developing the next St. Elsewhere or ER—came when the health system was introduced to a pair of Israeli showrunners who had developed successful documentaries and docudramas in Europe and wanted to expand to the UK and US.
The two, Ruthie Shatz and Adi Barnash, signed a contract with Northwell in 2017 to create Lenox Hill, a nine-part documentary on Lenox Hill Hospital that appeared on Netflix in 2020. The success of that show led to Emergency NYC, an eight-part documentary that aired on Netflix in 2023.
A third documentary series, called One South: Portrait of a Psych Unit, is now airing on HBO and some streaming services. It focuses on a unique program developed by Northwell at Zucker Hillside Hospital in Queens for college students at risk of suicide, and follows a handful of those students through their treatment.
And that’s when Northwell leadership decided to become a more active participant in the process.
One South “has been very beneficial in that regard to the point where we said, ‘Look, let's turn this into a business and let's do more of these,’” Soto says. Northwell Studios, launched this year, aims to produce at least two pieces of content per year.
It also highlights what Northwell wants to do with that medium.
“The reality is Northwell has millions of square feet of footage with which we dispense clinical care,” he notes. “We've got 21 hospitals, we’ve got 88,000 employees, hundreds of operating rooms, thousands of doors that consumers can walk through to engage with us, and that is my stage. So that’s where we capture the content, and it can be incredibly compelling content just given the number of people we touch: 2 million unique patient visits a year, 6 million patient encounters.”
Developing Northwell-branded content is tricky, given that the health system doesn’t want the public to assume this is carefully cultivated to make Northwell look good. Soto says story ideas are reviewed by a third party who is neither a Northwell employee nor a member of the production crew to ensure that the content is both entertaining and accurate. Contracts are carefully and meticulously drafted to ensure HIPAA compliance and patient privacy and safety, and the health system has a limited impact on the editing process.
Limited, but necessary. This is about more than just a stray Starbucks coffee cup showing up in Game of Thrones.
“It's fascinating to be in the edit room because I literally have a team of 20 people in there scrutinizing and you have typically a producer, director, maybe five people on the production side of it,” he says. “And we're not shy. Every once in a while you have the inadvertent camera scan across the room and a computer screen is up. And you know, our guys have heart attacks--not really, but we're just hyper-vigilant about that.”
And while Northwell’s doctors may be expert at treating patients and saving lives, that might not translate to the screen. Soto recalls a casting call for one production that drew 55 doctors for four roles—and having to deal with 51 doctors who didn’t make the cut.
“Picking doctors who know when the red light goes on” can be challenging, he says.
Soto noted that Northwell Studios won’t be making a profit for the health system—and that’s important, because Northwell Health is a non-profit entity. The value of this business venture, however, is significant. It’s far better than any billboard, TV ad or newspaper or magazine insert.
“This is about content creation that can do social good, that can benefit the communities that we serve and that allows us to develop brand [recognition],” he says, noting that 1% of all babies born in the U.S. are in Northwell facilities. “We really are intimate partners with consumers along their lives.”
It’s important, Soto says, to not only shine the light on healthcare’s heroes, but to direct that spotlight on important public health and population health issues, such as the high suicide rate among teens and young adults.
‘We lose $100 million a year on behavioral health services,” he says, “yet we created a two-episode docudrama on it because it’s an important social conversation right now.”
This is an easier way to draw blood, says this CNO.
HealthLeaders spoke to Anna Kiger, system chief nurse officer at Sutter Health, about how introducing technology for needless blood draws would improve the patient experience.
Virtual nursing is not a fad. It's so transformative that we are near the first generation of nurses who may never touch a patient.
Welcome to our August 2024 cover story. Each month, our editors will be taking a deep dive into the topics that matter most to you in our cover story series. From ways to win the payer/provider war to AI governance, we have a lot of stories up our sleeves this year.
So, what did our team look into this month? Well, nurses are feeling overworked and burned out, and there are not enough nurses to fill the gaps left by those leaving the industry. This means your hospital halls will soon be empty, but not for the reason you think. Your nursing staff will be virtual.
Many organizations are turning to virtual nursing to address staffing and wellbeing, and with the current trajectory virtual care will be an integral part of the future of healthcare.
So, while your rooms won’t be completely devoid of in-person nurses, soon an entire department of onsite clinical staff will be a thing of the past.
Our CNO editor G Hatfield spoke to some of the best in the industry in virtual nursing and dug into how nurse leaders can adapt and advance.
Did you miss our July cover story on the rise of the advanced practice provider? No worries, you can read it here.