The collaboration is one of several between health systems and Big Tech to develop and scale AI programs
A partnership between the Cleveland Clinic and IBM is applying AI to cancer care, with the goal of creating better and more effective treatments.
In a study recently published in Briefings in Bioinformatics, the research team reported that it was able to use both supervised and unsupervised AI technology to better understand the molecular details of peptide antigens, the first step in using them to attack cancer cells or cells infected with viruses. Researchers can use this data to tailor vaccines and engineered immune cells.
“In the past, all our data on cancer antigen targets came from trial and error,” Timothy Chan, MD, PhD, chair of Cleveland Clinic’s Center for Immunotherapy and Precision Immuno-Oncology and Sheikha Fatima Bint Mubarak Endowed Chair in Immunotherapy and Precision Immuno-Oncology, said in a press release. “Partnering with IBM allows us to push the boundaries of artificial intelligence and health sciences research to change the way we develop and evaluate targets for cancer therapy.”
The research proves the value of using AI to gather and analyze data faster and more accurately. According to the Cleveland Clinic team, antigen peptides interact with immune cells based on specific features on the surface of those cells.
“Research has been limited by the sheer number of variables that affect how immune systems recognize these targets,” Cleveland Clinic executives said in the press release. “Identifying these variables is difficult and time intensive with regular computing, so current models are limited and at times inaccurate.”
Using supervised and unsupervised algorithms “can highlight subtle but key determinants of peptide immunogenicity within the [atomistic molecular dynamics] trajectory data and can … provide significantly more predictive power over a baseline sequence architecture on peptide datasets,” the research team said in the study.
“These insights highlight how MD can help predict and foster understanding of immunogenicity, and the methods developed here lay a framework for broad HLA [ human leukocyte antigen] allele studies to further elucidate mechanisms of immune responses and inform T cell therapies,” they concluded.
The project was borne out of Discovery Accelerator, a collaboration launched in 2021 to match Cleveland Clinic’s biomedical research capabilities with IBM’s AI and quantum computing technology. It’s one of several partnerships forged between health systems and Big Tech to expand access to AI tools for research as well as administrative and clinical services.
The goal is to provide better patient care, say CNOs and CNIOs in the know.
With nursing tech disruption at a fever pitch, savvy CNOs and CNIOs are putting their heads together to ensure their investments make real impact. And there’s one place in particular where they’re setting their sights: virtual nursing.
Here's what CNOs should keep in mind when developing and integrating virtual nursing into their programs.
Health systems and hospitals are facing competition from disruptors offering personalized urgent and emergency care. But is that a bad thing?
A new disruptor is taking aim at the healthcare industry’s busiest site: The Emergency Department.
Concierge care programs designed specifically for urgent and emergency care are finding support from consumers who don’t want to wait several hours in an ED, along with primary care providers who don’t want to send their patients there. The service offers a cash-only alternative to the ED and could pull more patients away from hospitals and health systems.
“The experience [of an ED] is so challenging,” says Brad Olson, CEO of Sollis Health, which operates 11 clinics in New York City and the nearby Hamptons, as well as California and South Florida, and serves some 18,000 members. “What makes us different is we’re offering [patients] immediacy.”
Launched in 2016 in New York as Priority Private Care, Sollis is building a business model through partnerships with consumers, primary care providers, and businesses who want to avoid the traffic and time spent in an ED, which sees more than 130 million visits a year. The company offers a concierge care model that bypasses payers, and also offers a range of services that include diagnostics, labs and vaccines, virtual care, specialty care, even house calls.
The model adds another wrinkle to the crowded urgent care market, where hospitals and health systems are already competing with retail and stand-alone urgent care clinics that not only pull patients out of the ED, but offer additional resources and connections that pull a patient further outside the health system’s orbit of care.
Olson is quick to point out that Sollis Health is a disruptor, but not necessarily a competitor to health systems and hospitals—he notes the company has partnerships in place with more than 30 health systems for everything from ED services to specialty consults. He notes one clinic is located not far from Cedars-Sinai in Los Angeles and is partnering with the hospital even while giving consumers an alternative to Cedars-Sinai’s ED.
The ’disruptor’ moniker is important. Olson, a former executive with Peloton and Starwood Hotels & Resorts, brings a retail mentality to healthcare that is propelling companies like Amazon, Walmart, and Walgreens in the healthcare space. He notes that consumers are turning away from hospitals and health systems because of the complexity and cost of healthcare, and they certainly don’t want to wait several hours in a crowded hospital waiting room for fragmented care that leads to more scheduled visits in other locations.
Disruptors like Sollis Health and other concierge care companies are luring consumers away from traditional healthcare organizations with the promise of convenient, personalized care. And Olson says Sollis equips its clinics with ER-trained and boarded clinicians, many of whom also work at nearby health systems. Sollis also offers a range of services that stand-alone and retail urgent care clinics do not.
In the basic business model, Sollis Health partners with primary care providers and businesses who will refer their patients/employees to Sollis for urgent care, with those patients paying out of pocket for services. In some cases a PCP or business will purchase memberships for their patients or employees, figuring the cost of a membership will be much lower than costs associated with going to a hospital or urgent care clinic.
Olson says Sollis Health reaches out to health systems and hospitals to suggest partnerships, particularly in specialty care services, and those organizations haven’t sought out Sollis Health to help with crowded EDs. But the opportunity is there for healthcare executives to see disruptors like Sollis Health as a valuable resource, giving patients another option to access care.
“We definitely don’t compete with them,” he says.
Olson emphasizes that Sollis Health’s growth is in the consumer market, and in building out its concierge care to attract more primary care providers and businesses looking for alternatives to the ED or retail urgent care space. He says payers have expressed interest in this model of care, though the company currently isn’t working with any insurance companies and is focused on membership and cash-only payment plans.
“Our biggest challenge right now is explaining who we are and what we do,” he says. But once that connection is made, the value becomes evident.
Sanford Health recently tapped Scott Wooten, FACHE, MBA, as its new CFO. Wooten chatted with associate content manager Amanda Norris about how he plans to foster long-term success for the organization, as well as how he plans to make investments in growing its workforce—specifically in its graduate medical education program
This CNE has advice on how to create and foster a more diverse workforce.
On this week’s episode of HL Shorts, we hear from Dr. D’Andre Carpenter, Senior Vice President and Chief Nursing Executive at Allina Health, about strategies to improve recruiting and retention efforts by including diversity, equity, and inclusion (DEI) principles into the workplace culture.
What are some of the strategies CNOs can take to embed DEI into recruitment and retention culture?
I'm getting inspired by some work that I did at my previous system, [including] some [ideas] that we're talking about here at this system around promoting internal equity for team members that already exist in our organization.
We look at our supportive staff, our EVS transport, food and nutrition staff, that work elbow to elbow with our clinicians every day. A lot of them have aspirations of becoming clinicians, and [we look at if] we are being intentional about providing and setting up those pathway programs for them to be able to propel themselves into a clinical career, if that's what they desire to do. I think that's one that's just really low hanging fruit and easy, and it promotes internal equity in your organization.
You know, you're treating your family members that are local to your workforce as a part of the team and helping them grow their profession, [which is] another way to recruit and retain staff.
Participating providers will receive federal support for integrating mental and physical healthcare services in team-based care
The Centers for Medicare & Medicaid Services is launching a new model to test the integration of mental health and primary care services, giving healthcare organization an opportunity to leverage new strategies and technologies in a team-based care approach.
The Innovation in Behavioral Health (IBH) Model will be tested through the CMS Innovation Center (CMI), which will align Medicare and Medicaid reimbursements through state-based programs. The idea is to create a care management plan for patients living with mental health issues and/or substance use disorder that incorporates mental and physical healthcare.
“The systems of care to address physical and behavioral health conditions have historically been siloed, but there is a direct correlation between people with mental health conditions or substance use disorder and poor physical health,” CMS Deputy Administrator and Innovation Center Director Liz Fowler said in a press release issued Friday. “This model will bring historically siloed parts of the health system together to provide whole-person care--designed to keep people out of the emergency department, ensuring better care management and coordination, and improving their overall health.”
The eight-year program will launch this fall in as many as eight states. CMS is expected to release a Notice of Funding Opportunity sometime this spring.
The model lends federal support and funding to a concept being tested by healthcare organizations across the country. Faced with an onslaught of patients living with behavioral health issues and a shortage of resources, providers are turning to team-based care to give these patients a more comprehensive care plan. The team-based approach also supports the theory that many behavioral and substance abuse issues stem from or are exacerbated by other health concerns, including chronic conditions.
The model also enables providers to fold in services and resources that address barriers to care, or social determinants of health (SDOH), to affect many underserved patients, especially those in Medicare and Medicaid programs.
“Addressing the nation’s behavioral health crisis remains a key priority for CMS,” CMS Administrator Chiquita Brooks-LaSure said in the press release. “Through this model, CMS will support behavioral health practices to provide integrated care and help meet people’s behavioral and physical health and health-related social needs, like housing, food, and transportation, all of which can negatively impact a person’s ability to manage their care.”
CMS officials say the model will incentivize participating providers “to work collaboratively to screen, assess, and coordinate between individuals’ physical and behavioral health needs.” The model also gives providers a chance to use virtual and digital health technologies to improve access to treatment and support services.
Start small to grow sustainably, and keep the right people plugged in, say CNOs and CNIOs in the know.
With nursing tech disruption at a fever pitch, savvy CNOs and CNIOs are putting their heads together to ensure their investments make real impact. And there’s one place in particular where they’re setting their sights.
“I think virtual nursing is definitely on the mind of every CNO, or it should be,” says Natalie Nicholson, DNP, MBA, RN, CENP, NEA-BC, associate chief nursing officer at Denver Health, which has more than 8,000 employees across its main hospital and nearly 40 additional care locations. The organization identified a virtual nursing vendor through an RFP process and plans to roll out its program this year.
Nicholson and her team are not alone. Two-thirds of U.S. chief nursing officers are already interested in, researching, or deploying virtual nursing, says Bonnie Clipper, DNP, MA, MBA, RN, CENP, FACHE, FAAN, founder and CEO of Innovation Advantage, a healthcare innovation consultancy specializing in the model.
Driving the trend is an aging population who’s requiring more care and a shortage of clinicians to provide it.
“It’s no surprise that nursing has taken a major hit with COVID in terms of staffing,” says Kathi Zarubi, DNP, MBA, RN, senior vice president and chief nursing officer at HonorHealth, which has six hospitals and more than 70 additional care locations throughout Arizona. “All hospitals in the country are trying to figure out how to safely staff.”
Zarubi sees virtual nursing as a key part of the solution, and she has led her organization in launching a pilot at one of their Phoenix medical centers in December.
Denver Health and HonorHealth’s CNO-CNIO teams share what it takes to stand up and evolve a virtual nursing program that fosters quality care and human connection from both sides of the screen.
On Team Nursing 2.0
In virtual nursing, a remote clinician can handle administrative duties that, though essential, could take time and energy away from bedside care. Zarubi says these duties often include admission or discharge documentation, as well as patient education about things like a new medication’s side effects. It’s the power of two nurses, one at the bedside and the other on the screen, combining brain power and bandwidth to better patient care.
Virtual nursing could represent the next evolution of team nursing, CNOs and CNIOs say. The context has changed significantly since the model emerged in the 1950s.
When deciding whether and how to implement virtual nursing, center your north star, CNOs and CNIOs say. Hint: It should involve high-quality care and safety.
Other objectives may include nurse recruitment, retention, and efficiency, as well as cost.
“Health systems across the nation are in financial burdens right now,” Nicholson says.
From there, Zarubi says, be sure to ask the right questions, such as “How do I retain these very precious nurses, and how do we make the work enjoyable and not a burden?”
With these big-picture considerations in mind, look to prospective end-users—both nurses and patients—to shape strategy.
With five of its six hospitals Magnet-recognized, HonorHealth already had a framework in place for sourcing input on its pilot plans, Zarubi says.
“Magnet is really a structure that supports the individual bedside nurse having a large say in how things function and the governance of care,” she says.
At HonorHealth, that looks like a transformation office that Larson co-leads with nursing colleagues to create technology solutions that support organizational strategy. Outputs flow monthly to a nursing informatics council, where, in any given meeting, about 50–60 frontline staff, clinical directors, and CNOs across care settings and locations weigh options and make decisions. For larger-scale initiatives, Larson taps a clinical technology experience council, another multidisciplinary body that brings physicians, nurses, and other clinicians to the table to help decide whether solutions under consideration should move forward.
“We really want it to work for the organization, and not just today, but in the long haul,” Zarubi says. “So these kinds of councils allow us to take a look at those technologies from that standpoint and get all the users at the table to provide their input.”
The same goes for gathering input from patients and their loved ones through a dedicated advisory council, which has been a fixture “for many years,” she says.
“Measuring the patient perspective, and the actual patient and family experience with any new technology, to me, is very important,” she says.
On Winning Hearts and Minds
Beyond empowering end users to define priorities and make decisions, CNOs and CNIOs can set programs up for success by addressing concerns head on.
“We’re not eliminating nurses by any means,” Zarubi says. “That is not the goal. The goal is to supplement the care and provide an even better experience for our patients.”
It’s also important to find champions to reinforce this message.
“It’s a win, and we've experienced that over the years with any new technology or any new piece of equipment,” Nicholson says. Some of Denver Health’s nurses also work at a nearby hospital that’s implemented virtual nursing and have been singing that program’s praises.
“Those nurses are like, ‘It’s amazing, you'll love it,’ ” she says.
The good news is that the state of nursing today means fear of the unknown is often tempered with such excitement.
“Because the nurse market is so positive, I don't think nurses are as fearful for their positions as they probably would be for other positions,” says Nicole Myers, MSN, RNC, associate chief nursing informatics officer at Denver Health.
On Choosing the Right Tech
Once the vision is set, it’s time to talk tech. Myers recommends using a roadmap to visualize initiatives coming down the pike, how they roll up to organizational goals, and whether new or existing technology might enable their success through well-sequenced actions.
For virtual nursing programs, selecting the right vendor is a crucial step. Here, CNOs and CNIOs say, focus on the seamlessness of integration with current EHR software.
Denver Health, which uses Epic, closely vetted companies that responded to their RFP to ensure implementation and maintenance wouldn’t require outsized IT effort or additional personnel, Myers says. Such technical debt is not always on a CNO’s radar, but it should be, especially given the financial strain so many are feeling.
Similarly, think long and hard about which premium features are nice-to-haves, rather than day-one musts.
“We don’t truly need every bell and whistle, and I think the nurses would agree with that on the floor,” Myers says.
Also, look at the backend to ensure prospective software offers helpful analytics, Larson says.
“Does it support our processes?” she asks. “Are we getting the output in the data that we're looking for?”
On Starting Small to Grow Sustainability
When it’s time to pilot, the prevailing advice is to start small.
That approach “allows time for change to be adapted, and to be accepted, and then start rolling it out into other areas,” Nicholson says. She and Myers plan to preempt virtual nursing services like admissions and discharges with virtual sitter services.
Zarubi and Larson are taking a similar tack. They launched their program on a single floor at one of their medical centers last month, and the laser focus has allowed them to expand quickly to all three floors earmarked for the pilot. Now, they’re refining based on early learnings and planning a full study on their nurses’ experience.
Although they’re still crunching the numbers, early signs point to improved patient experience. They’re hopeful about nurse retention, too.
“We’re trying to find that magic balance for that bedside nurse to try to get them to really enjoy their nursing experience and to home in on why they went into nursing to begin with,” Zarubi explains.
On Making Virtual Nurses Feel at Home
When laying plans, don’t forget about the people behind the screen, CNOs and CNIOs advise.
Nicholson likes the requirement she’s seen for virtual nurses to have at least three years of hands-on experience.
“I think that's fantastic; more would even be better,” she says. “There is a level of maturity and understanding when you've been in nursing for three to five years, and you can pick up on things that a new nurse takes a little bit more time to learn or recognize. It’s just experience. It’s just miles.”
In this way, the model also shows promise for mentorship by empowering veteran nurses who may not want or be able to work on the floor to impart wisdom to recent graduates at the bedside.
“They can present and have their clinical skills, or their clinical brains, shared with newer nurses and teach them and also be taking care of patients,” Nicholson says.
That’s why virtual nurses should be treated like part of the team. Even though HonorHealth’s remote partners are based outside Arizona, Zarubi and Larson onboard them “like they’re our own employees so they understand our goals and our values, our vision, our mission.”
That ethos carries all the way through to their virtual background, which displays the HonorHealth logo.
“It provides that seamless experience that they are one of our members of the care team,” Larson explains.
It also reinforces the humanity of it all.
“We don't want robotic nurses,” Zarubi says. “We want real life human beings that have a human connection.”
This leader discusses how to bridge the gap between health systems and unions.
Recently, there has been an increase in nursing strikes and union activity throughout the United States.
Nurses are frustrated, and the recent union activity is indicative of large, widespread problems in the nursing industry with staffing, work environment, and nurse wellbeing. While it is the CNO’s responsibility to address those issues and to facilitate those conversations, it can be quite difficult.
To get the bigger picture, we sat down with Katie Boston-Leary, Director of Nursing Programs at the American Nurses Association, to discuss the underlying causes of strikes and how to communicate with unions to achieve better outcomes.
Healthcare CFOs know the pandemic cost them big, but now there's a number attached for one state.
After years of tight margins made worse by the pandemic, many hospitals are beginning to feel a measure of relief. But how much financial strain did the pandemic really put on hospitals and health systems?
In Pennsylvania, it was $8.1 billion worth of strife.
You read that right. The total COVID-19 related expenses and lost revenue reported by Pennsylvania hospitals and health systems between January 2020 and December 2022 were $8.1 billion, according to the report by The Pennsylvania Health Care Cost Containment Council and The Hospital and Healthsystem Association of Pennsylvania.
While this report only spotlighted Pennsylvania, there are a few key insights that are applicable to CFOs nationwide.
So what was the true financial impact?
As mentioned, Pennsylvania hospitals and health systems reported a staggering $8.1 billion in total COVID-19-related expenses and lost revenue during the pandemic.
Although most hospitals and health systems remained financially stable due to COVID relief funds, those funds have since dried up while the same challenges still exist.
Of this sum, COVID-19 staffing costs emerged as the most significant expenditure, reaching $1.3 billion. According to the report, other costs included:
Testing expenses: $374 million
Supplies and equipment expenses: $679 million
Construction expenses: $28 million
Housing care expenses: $9 million
Other expenses: $434 million
Revenue loss: $5.3 billion
When it comes to the staffing costs, the amount highlights the immense financial strain incurred by hospitals in responding to the staffing demands posed by the pandemic. CFOs still need to scrutinize these figures to gain a nuanced understanding of where financial resources were concentrated and explore avenues for financial resilience moving forward.
The report also shed light on how the pandemic has exacerbated workforce shortages in Pennsylvania's healthcare sector.
Hospitals reported an average statewide vacancy rate of over 30% for key clinical positions, such as registered nurses, nursing support staff, and medical assistants, by the end of 2022.
This intensification of workforce shortages continues to pose an ongoing challenge to hospitals, hindering their ability to provide comprehensive care and potentially impacting patient outcomes. And as we know, these staffing shortages have been the catalyst to the increasing number of workforce strikes.
As mentioned, CFOs must strategize to address staffing shortages, focusing on recruitment, retention, and workforce optimization.
But what about other states?
A previous study showed that COVID-19 care prompted higher operating expenses and rapidly escalating labor costs for CFOs nationwide. In fact, hospitals in the United States experienced a total loss of over $200 billion because of an estimated 45% decrease in operating revenue just between March and June of 2020.
Pennsylvania's data through 2022 gives healthcare CFOs across the nation a granular look into these costs, providing valuable insights into the continued long-term financial repercussions of the pandemic.
The report's focus on COVID-19-related expenses and lost revenue underscores the continued need for robust financial planning and risk management, especially as many CFOs are still clawing their way out of the red.
CFOs should conduct thorough audits of their institutions' pandemic-related financial data, identifying areas for potential cost containment and revenue enhancement. Leveraging data can not only assist CFOs in forecasting future financial scenarios and implementing proactive measures, but help them push their current margins in the right direction.
Two leaders share their insights and strategies to help CNOs work together with staff and problem solve.
Right now, it seems like every day there are new cases of nurses striking or unionizing at health systems all across the country.
Nurses are frustrated, and the recent union activity is indicative of large, widespread problems in the nursing industry with staffing, work environment, and nurse wellbeing. While it is the CNO’s responsibility to address those issues and to facilitate those conversations, it can be quite difficult.
Here's what CNOs should know about preparing for strikes.
