Latest / Becker’s Payer Issues Podcast / Intent, Integration, Impact: Jefferson Health's Operating Model for AI & Real Care

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Intent, Integration, Impact: Jefferson Health's Operating Model for AI & Real Care · Becker’s Payer Issues Podcast

• 0:00
  - Hi, everyone. This is Brian Zimmerman with Becker's
• 0:02
  - Healthcare. Thank you so much for tuning into
• 0:04
  - the Becker's Healthcare podcast.
• 0:06
  - Today, we're gonna talk about intent, integration,
• 0:09
  - impact, Jefferson Health's operating model for AI in
• 0:12
  - real care.
• 0:14
  - Joining me for this discussion is doctor Patricia
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  - Henwood,
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  - executive vice president, chief clinical officer with Jefferson
• 0:20
  - Health. Doctor Henwood, thank you so much for
• 0:22
  - being here today. Can you introduce yourself to
• 0:24
  - our audience and tell them a little bit
• 0:26
  - about yourself and and and the work you're
• 0:28
  - doing now?
• 0:29
  - Yeah, Brian. Thank you so much for having
• 0:31
  - me. Glad to be here today. As you
• 0:33
  - mentioned, I'm the chief clinical officer at Jefferson
• 0:35
  - Health. We're a 33 hospital system in, Pennsylvania
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  - and New Jersey. I'm also a professor of
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  - emergency medicine and population health
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  - and, help lead our AI strategy at Jefferson
• 0:46
  - Health, in addition to focused work on improving
• 0:49
  - outcomes for our patients and communities.
• 0:53
  - Yep.
• 0:54
  - Excited to dig in and and hear more
• 0:55
  - about that. Wanna start here, which is, you
• 0:58
  - know, you all just hosted an AI summit
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  - in in Philadelphia
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  - in October October twenty one, I believe it
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  - was. Can you talk a little bit about
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  - the why behind that that that summit, and
• 1:08
  - and what were some of the takeaways from
• 1:09
  - the meeting? What did you learn?
• 1:11
  - Yeah, Brian. Glad to discuss.
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  - I think from our perspective, we recognize that
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  - AI adoption in health care is inevitable, but
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  - the impact of that is not.
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  - And we wanted to ensure the the conversation
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  - around meaningful impact and how we can,
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  - move from conversations around tools and,
• 1:31
  - implementations
• 1:32
  - themselves to, I think, the broader conversation around,
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  - really, the future design of care delivery,
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  - what the implications of AI are for professional
• 1:42
  - practice,
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  - for education.
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  - We have a a university and one of
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  - the largest medical schools in the country as
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  - large... As well as one of the largest
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  - GME training programs in the country. And so
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  - I think a lot of focus that we
• 1:55
  - have in thinking about not only what does
• 1:57
  - this mean for care delivery today, but how
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  - are we thinking about,
• 2:01
  - bringing considerations on AI's impact into, the trainees
• 2:05
  - of tomorrow,
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  - across health professions, not just our medical students,
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  - and really focusing on trying to shift the
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  - conversation again from
• 2:13
  - a lot of the tool specific,
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  - discussions that we've been seeing to more of
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  - the focus on how can we leverage AI,
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  - in delivering outcomes that we're looking for across
• 2:23
  - health care.
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  - Excellent. And can you can you talk even
• 2:27
  - more about just why that's so important to
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  - get to a place where,
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  - you know, it's not just theoretical anymore. Right?
• 2:33
  - You're you're you're making things practical and tangible
• 2:36
  - for for for these leaders. Can you talk
• 2:37
  - a little about why it's so important to
• 2:39
  - move medicine forward in this way? Yeah. I
• 2:42
  - mean, I think it's very important based on
• 2:44
  - how fast the AI landscape is moving that
• 2:47
  - we are thinking and taking the time,
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  - to be intentional
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  - of how it comes into care delivery. I
• 2:53
  - think we're concerned, otherwise, it will happen to
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  - us, and we need to really think about
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  - steering how AI gets integrated into training and
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  - care delivery
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  - in an intentional way. I think we see
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  - that there is, so much activity in the
• 3:07
  - health AI landscape.
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  - But sometimes that's... Those conversations may often be
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  - vendor driven, or we have a lot of
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  - conversations,
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  - happening with health systems and potential tech partners,
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  - but not as much amongst,
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  - the entire ecosystem and not as much amongst
• 3:22
  - health systems. So we really were trying to
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  - bring the conversation together and thinking about a
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  - more collaborative,
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  - health AI ecosystem and how we can continue
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  - to think and learn from each other as
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  - we're, you know, living in this very fast
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  - moving,
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  - AI landscape.
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  - Yeah. Yeah. Really important. And and and, you
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  - know, probably some learnings there too about,
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  - when technology has perhaps happened to health care.
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  - Right? And and trying to... Try trying to
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  - avoid that that that scenario with this very
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  - powerful, very transformative technology.
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  - Yeah. I think we we certainly see that.
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  - You know, we do not wanna have more
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  - considerations where we have just AI becoming this
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  - bolt ons,
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  - in different areas, and we've seen in health
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  - care so often. Right? We just keep adding
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  - onto
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  - existing systems and processes, and and we don't
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  - take the time to really,
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  - have a first principles
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  - consideration
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  - of, you know, how should this work? What
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  - would idea look like?
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  - Where can we redesign
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  - care delivery or work flows instead of, you
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  - know, further automating
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  - imperfect workflows that just start taking us, you
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  - know, further down the wrong direction.
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  - Right. Right. I wanna get to now too
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  - sort of,
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  - Jefferson presented at the the National Academy of
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  - Medicine this month on what it takes to
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  - make the learning health system real. I I
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  - I would I would... I think it's fair
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  - to say most systems probably share that goal.
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  - What is the operating piece most of them
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  - are maybe missing, and how did how did
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  - Jefferson build it? How did you make that
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  - a reality?
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  - Yeah. Agree. I think a lot of us
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  - share that, vision that the National Academy has
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  - put forward and and others around the learning
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  - health system, but I I do think making
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  - it a reality is something that requires,
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  - a bit more,
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  - intentionality
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  - in how we take that vision into action.
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  - For us at Jefferson, we have,
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  - focused on an accountable operating model to do
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  - that. We call it OnPoint,
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  - is our operating model, our care operating model
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  - at Jefferson.
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  - And that really entails us thinking very intentionally
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  - around people, process, and technology,
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  - recognizing the complex socio technical system that care
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  - delivery,
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  - is happening and,
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  - that we really need to think about people,
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  - and that may be... Depending on the case,
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  - that may be our patients or our community
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  - members. That may be our health care, workforce
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  - in particular or leaders that we need to
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  - engage in different processes.
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  - The the processes, how the work actually gets
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  - done, versus,
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  - I think our sometimes imagination of how things
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  - happen or how things should look on paper
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  - versus how they're happening in reality.
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  - And then technology, how we can leverage technology
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  - to actually,
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  - drive and support the outcomes and support our,
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  - clinicians and our care teams in delivering those
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  - outcomes,
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  - rather than, again, more of the the bolt
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  - on or technology for technology's sake. So,
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  - really, the... Our, care operating model focuses on
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  - how these three things interact to deliver outcomes.
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  - And, again, we have a focused team,
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  - that's really thinking about what our priority should
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  - be and how we can work across these
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  - different,
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  - areas of people process and technology,
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  - in order to drive those improved outcomes that
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  - we're looking for.
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  - I wanna build on that because I think
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  - what you're what you're getting at too is
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  - is really
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  - measuring value, getting to the value of of
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  - the technology. And
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  - so most health systems now, it's probably safe
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  - to say they have an AI governance committee.
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  - But why hasn't that turned into more value
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  - for folks? And and can you unpack Jefferson's
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  - I three approach, which is intent, integration, and
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  - impact,
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  - and how you add that on top of
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  - governance to really get that value and measure
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  - it?
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  - Yeah, Brian.
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  - Agree. Governance is something that is obviously critically
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  - important, but we see that as something that's
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  - necessary but not sufficient.
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  - And we recognize that there are so many
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  - tools that are coming in that,
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  - seem like they have potential and or we
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  - hear anecdotally about potential, but we wanna make
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  - sure that we're really,
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  - taking that time to think about what the
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  - right things to incorporate into the system are.
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  - So for us, that framework is really, something
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  - that our on point program,
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  - has sort of built upon these principles and
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  - that we really crystallize with our AI stewardship
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  - approach.
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  - Intent for us is is focusing on the
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  - why. You know, what problems matter?
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  - Why are we looking at this solution for
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  - a problem? Is that something we wanna prioritize?
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  - Integration is really the how.
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  - You know, how is this tool gonna come
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  - in? How is the work actually done?
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  - What roles need to change if we're thinking
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  - about incorporating, you know, this tool or a
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  - different workflow?
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  - Impact is really the so what. What outcomes
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  - are actually better and what decisions
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  - come from, from the consideration of integrating,
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  - AI or changes in that sociotechnical
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  - system. So,
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  - for us, that's something that's been really helpful
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  - in making sure we're focused on on platforms
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  - and putting our attention in the right place
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  - to drive value, and then also using that
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  - to make sure we're circling back to ensure
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  - we're having the intended,
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  - impact that we're looking for in areas like
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  - our, Ambient AI deployment,
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  - other tools that we're using.
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  - Really fascinating. And, doctor Hemwood, can you tell
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  - me a little bit more about the Ambient
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  - deployment and what what what that has been
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  - like for you all?
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  - Yeah. Glad to discuss that a little bit
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  - more. For us, it has been, an area
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  - where we've had that focus on returning time
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  - to care and that we've actually seen a
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  - lot of success with the tool.
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  - We were hearing such good things from our,
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  - clinicians and users and,
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  - and not not hearing anything negative from a
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  - patient feedback standpoint, but that was something that
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  - we really wanted to, again, assess that impact
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  - further.
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  - So we actually have a study that came
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  - out, in New England Journal Catalyst about Ambient
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  - AI as a tool for returning time to
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  - care where we focus not only in looking
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  - at our, clinicians
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  - in the ambulatory setting that we're using, Ambient
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  - in their, visits, but also looking at,
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  - the patient experience,
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  - surveys matched with those encounters.
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  - And we we felt that it was important,
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  - again, to think about not only our clinician
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  - experience but also the patient experience in that
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  - space. And we're,
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  - pleased to find that our Ambient encounter scored
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  - equal or higher in, every domain from a
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  - patient experience standpoint,
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  - as well as,
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  - significant effort reduction for our clinicians,
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  - decrease in pajama time,
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  - for our clinicians, which is so important for
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  - them to not have to take their, work
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  - home and be doing, charts, you know, at
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  - home in the evening or the weekends,
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  - faster chart closure.
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  - And so just really, I think, great results
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  - that we are seeing in our,
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  - again, intentional approach to think about tools that
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  - can help, deliver value,
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  - improve the experience or, you know, maintain the
• 10:09
  - experience for teams while we're also thinking about
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  - how we can,
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  - address some of the burdens that we know
• 10:15
  - are, on our clinical teams.
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  - Yeah. Yeah. Fascinating to hear about how this
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  - is influencing the experience of clinical teams. I
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  - also wanna maybe we... Maybe switch... And and
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  - it says, apparently, the patients are enjoying this
• 10:27
  - as well, but wanna get to perhaps even
• 10:29
  - more patient facing technology with this next question.
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  - So AI voice agents are now calling patients
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  - about scheduling
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  - care gaps and and follow-up care.
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  - So in these scenarios, in these situation,
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  - a call can start as an operational task
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  - and really turn clinical quickly.
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  - How has Jefferson approached this, you know, patient
• 10:47
  - facing AI? And and what have you done
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  - to to to keep it safe as it
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  - scales when you're building this?
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  - Yeah. I think, certainly, we see it as
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  - a as a really incredible opportunity for us
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  - in delivering our mission to improve lives where
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  - we can enhance that care connection more with
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  - patients. But that in bringing in this agentic
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  - voice technology, we really have to think about
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  - kind of going slow at the front so
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  - that we can scale faster.
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  - We focused on that similar approach of making
• 11:15
  - sure we're creating systems and understanding
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  - the people process technology that are involved and
• 11:20
  - that if we create those systems at the
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  - outset, such as the work that we're doing
• 11:24
  - with Hippocratic AI now and Agentic Voice,
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  - we can then essentially go faster if we
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  - have that system and the safety and the
• 11:32
  - the confidence in that system.
• 11:33
  - We we recognize to your point that these
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  - scheduling calls,
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  - that we started with initially, we knew we
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  - had to put a lot of the processes
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  - in place in case something clinical were to
• 11:44
  - surface on those calls. And that each call,
• 11:46
  - while it might have been intended as a
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  - a scheduling call, could turn into a clinical
• 11:50
  - interaction and that we need to be confident,
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  - in where we were,
• 11:55
  - going and where we were reviewing things and
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  - and, again, having the confidence in the system
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  - to perform,
• 12:00
  - in those cases. So we created a,
• 12:04
  - a dedicated clinical safety and advisory council,
• 12:07
  - with essentially a wise table of our senior
• 12:10
  - clinicians and leaders to think about which use
• 12:13
  - cases,
• 12:14
  - we felt comfortable in,
• 12:16
  - advancing in the agentic voice platform and, you
• 12:19
  - know, considering the monitoring,
• 12:21
  - to that earlier point in tracking the outcomes,
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  - how we're looking at, how things are performing,
• 12:26
  - where we might need to design or redesign,
• 12:29
  - and making sure that we have input from
• 12:30
  - that group as well as input that we
• 12:32
  - get from our patient and family,
• 12:34
  - advisory committee as we're thinking about further incorporating
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  - this into care delivery. So I think that
• 12:39
  - approach for us in going slow to go
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  - fast,
• 12:42
  - is, I think is paying dividends as we
• 12:45
  - start work on more use cases in the
• 12:47
  - agentic voice,
• 12:49
  - platform based on initial successes that we've seen
• 12:52
  - and,
• 12:53
  - safety that we've seen.
• 12:55
  - Yeah. It it... Couple follow ups here for
• 12:57
  - you, doctor Henwood, in terms of what kind
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  - of volumes are you seeing now with with
• 13:01
  - with these kind of calls? How how many
• 13:03
  - interactions is is is this actually... You know,
• 13:05
  - how many patient interactions does this add up
• 13:07
  - to? And I guess maybe what surprised you
• 13:10
  - about this process?
• 13:12
  - So we've, again, been working kinda slow to
• 13:15
  - go fast, but we've been working with the
• 13:16
  - Hippocratic team over the last couple months, and
• 13:18
  - we've had
• 13:20
  - outreaches to over 15,000
• 13:22
  - patients.
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  - Within that, we've had 1,500,
• 13:26
  - successful,
• 13:27
  - connections with those patients.
• 13:29
  - And we have seen some interesting results and
• 13:32
  - success in one of the early use cases
• 13:33
  - that we launched,
• 13:35
  - within a couple weeks of starting with the
• 13:36
  - team was in the mammography
• 13:39
  - care gap area.
• 13:40
  - We felt like that was a safe area
• 13:42
  - for us to initially
• 13:44
  - move in connecting patients that we knew had
• 13:46
  - scheduled,
• 13:48
  - had orders for mammography but hadn't scheduled them.
• 13:51
  - And we've been able to,
• 13:52
  - connect and schedule several 100 of those patients,
• 13:55
  - that we essentially otherwise wouldn't have had the,
• 13:58
  - the human capacity or the bandwidth to reach
• 14:00
  - out on those scheduling. So I think that's
• 14:02
  - an area where we see the opportunity to
• 14:04
  - leverage this in improving outcomes,
• 14:06
  - that we see some of that success. And
• 14:09
  - from a surprising standpoint, I think some of
• 14:11
  - the work in our, in our health plan,
• 14:14
  - we've been doing, member welcome calls.
• 14:16
  - And we've seen there that, the duration... Average
• 14:19
  - duration of those calls is around fifteen minutes.
• 14:22
  - And the, the satisfaction,
• 14:25
  - of our members in the interaction with the,
• 14:28
  - agentic voice platform
• 14:30
  - has been, you know, more than nine out
• 14:32
  - of 10 and higher than,
• 14:34
  - higher than it was at a baseline with
• 14:36
  - the team that had been doing that previously.
• 14:38
  - So we're having a higher rate of, actually
• 14:41
  - connecting with our patients... Or sorry, with our
• 14:43
  - members for new new member welcome call, and
• 14:47
  - we're also seeing higher satisfaction there. So I
• 14:49
  - think that is,
• 14:50
  - those are the kinds of wins that we're
• 14:52
  - looking for and looking to build on some
• 14:54
  - of that momentum forward.
• 14:55
  - Yeah. Really, really, really fascinating to think about
• 14:57
  - just the volume of this. You know, it
• 14:59
  - wouldn't be possible without this technology, but you're
• 15:01
  - also... To to your last point there, you're
• 15:03
  - also deepening some interactions here and and getting
• 15:06
  - off to a stronger foot, especially in that
• 15:08
  - that member situation. Right? You're sort of maybe
• 15:10
  - deepening that that relationship. Is that fair?
• 15:13
  - Yeah. Exactly. I mean, one of the the
• 15:14
  - areas,
• 15:15
  - we've had a focus across Jefferson is a
• 15:18
  - a focus on returning time to care.
• 15:20
  - And in that, we have a couple of
• 15:22
  - areas that we're focused. Where are we focused
• 15:24
  - on enhancing that care connection?
• 15:27
  - Where can we reduce some of that,
• 15:29
  - administrative burden for our clinicians? And where can
• 15:31
  - we strengthen the care operating system overall and
• 15:34
  - and some of the, nonclinical functions of the
• 15:37
  - system? So for us, that agentic voice, we're
• 15:40
  - looking at that and enhancing a care connection
• 15:42
  - with our patients, as part of why, again,
• 15:44
  - we have that clinical safety advisory council where
• 15:47
  - we're looking not only at the outcomes of
• 15:49
  - those calls, but, again, looking at the satisfaction
• 15:51
  - piece and our patients, or members' experience so
• 15:54
  - that we can make sure that that's something
• 15:57
  - that is helping to, you know, get them
• 15:59
  - to care,
• 16:00
  - get them awareness around the, the coverage that
• 16:03
  - they have with the health plan,
• 16:05
  - and making sure that we are achieving those
• 16:07
  - goals and the outcomes that we have, but
• 16:09
  - also ensuring that it's something that is, serving
• 16:12
  - as a point of engagement,
• 16:14
  - with our patients and members. Because, again, the
• 16:16
  - the use cases that we've focused on are
• 16:18
  - ones where we wouldn't otherwise have had the
• 16:21
  - capacity to, connect with those patients. So,
• 16:24
  - we're pleased with that.
• 16:26
  - Yeah. Yeah. Certainly. I wanna wanna move here
• 16:28
  - to to our final question, doctor Han Wood,
• 16:30
  - which is,
• 16:32
  - just to get a bit of advice from
• 16:34
  - you for for listeners out there. So
• 16:36
  - for for listeners that might be at a
• 16:38
  - health system sort of struggling to achieve full
• 16:40
  - value of their their AI investments,
• 16:42
  - what's the first thing to get right?
• 16:44
  - And what would you advise sort of maybe
• 16:46
  - even the board to ask to know whether
• 16:48
  - the strategy is working? What questions should they
• 16:50
  - be asking?
• 16:52
  - Well, I think from a big picture perspective,
• 16:55
  - having a strategy, one, I think that's something
• 16:57
  - that,
• 16:58
  - many don't. And when there's so much opportunity
• 17:01
  - and there's so much coming at us as
• 17:03
  - system leaders or even our clinicians
• 17:05
  - at the front line in in terms of
• 17:07
  - tools, having a strategy around how you're thinking
• 17:09
  - about bringing AI into care, I think number
• 17:12
  - one, can be very helpful in in helping
• 17:14
  - to steward that and not, distract,
• 17:17
  - with tools that might not get the outcomes
• 17:19
  - that we're looking for.
• 17:20
  - Overall, I think, you know, that, I three
• 17:23
  - framework that we were talking about earlier,
• 17:25
  - that focusing on intent. You know, what are
• 17:27
  - problems that matter to you,
• 17:30
  - or to your system, and what are issues
• 17:32
  - that you're trying to solve? Not a tool,
• 17:34
  - looking for a problem, but more of the
• 17:36
  - problem that, you know, aligns strategically for the
• 17:39
  - organization.
• 17:40
  - And then what's... What are outcomes that you
• 17:42
  - can measure associated with that? You know, that
• 17:44
  - would be the impact that you'd be tracking
• 17:46
  - towards.
• 17:47
  - And then really understanding,
• 17:48
  - you know, that that integration component, who is
• 17:51
  - going to be doing the
• 17:53
  - discovery work to understand how that work is
• 17:55
  - really done, how it might need to be
• 17:57
  - reimagined or redesigned, and and who's accountable for
• 18:00
  - that. So
• 18:01
  - I think the focus on, teams, like the
• 18:03
  - on point team that actually have that focused
• 18:06
  - accountability for
• 18:07
  - integrating these tools or redesigning the work is
• 18:10
  - really important,
• 18:11
  - because we've seen again and again, that if
• 18:14
  - you don't have that focus on how the
• 18:16
  - technology is gonna be integrated, then oftentimes, you
• 18:19
  - do not get the value that you're, you
• 18:21
  - know, driving for or anticipating
• 18:22
  - at the outset.
• 18:25
  - Very well said, doctor Henwood. Thank you so
• 18:27
  - much for for taking the time to speak
• 18:29
  - with me today and coming on the podcast.
• 18:31
  - Thanks, Brian. I appreciated the opportunity to chat
• 18:33
  - with you. Absolutely.
• 18:35
  - Folks, you can tune in to more podcasts
• 18:37
  - from Becker's Healthcare by visiting our podcast page
• 18:40
  - at beckershospitalreview.com.
• 18:42
  - Thank you so much.