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Scaling AI in Healthcare with Governance, Trust, and Impact at City of Hope · Becker’s Healthcare Digital Health + Health IT

• 0:00
  This is Laura Dirda with the Becker's Healthcare
• 0:02
  Podcast.
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  I'm thrilled today to be joined by Simon
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  Nazarian, executive vice president and chief digital technology
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  officer at City of Hope, Nassim
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  Eftikari,
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  who is the chief AI and analytics officer
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  at City of Hope. Nasim, Simon, thank you
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  so much for joining us on the podcast
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  today.
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  Happy to be here. Great. Thanks for having
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  us.
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  Fantastic. Well, I'm looking forward to learning more
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  about everything you're doing at City of Hope.
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  I know it's a fantastic organization, really innovative
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  and on the cutting edge of what's happening
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  in cancer care today and more. So I'm
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  excited to dig in. But before we do,
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  can you tell me a little bit more
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  about yourself? Give us a a bit of
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  your backgrounds and then, a little bit about
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  City of Hope too.
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  Fantastic.
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  I can start.
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  Hi. My name is Simon Nazarian,
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  and, I'm the executive vice president and chief
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  digital and technology officer
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  for City of Hope. And,
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  you know, it's a exciting role we're playing
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  today,
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  especially, since City of Hope,
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  was founded in 1913.
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  We've been focused on providing compassionate care to
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  people in need.
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  And, you know, we really focus on what's
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  best for our patients, and that guides everything
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  that we do.
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  And in the past several years, City of
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  Hope, has experienced tremendous growth.
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  We're one of the largest and most advanced
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  cancer research and treatment organizations in The US
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  and, ranked among the nation's top cancer centers
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  in The US. We're very proud of that.
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  You know, City of Hope's, NCI designated
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  comprehensive
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  cancer center
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  received the highest rating, from the NCI,
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  and that puts us, City of Hope, in
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  the top echelon of the nation's,
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  you know, 57
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  NCI designated comprehensive cancer centers.
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  And,
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  the
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  and we are system wide, so we are
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  in five major metropolitan
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  areas,
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  including LA, Orange County, Chicago, Atlanta, and Phoenix.
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  And, 86,000,000
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  people live in
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  communities with close access to one of our
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  facilities.
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  K?
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  And, you know, in my role, I,
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  you know, oversee,
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  digital technology enterprise platforms
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  that really support,
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  care at scale. So anything that has to
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  do with technology rolls up to my organization.
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  And, you know, in partnership with Nasim, really
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  focused on how innovation actually moves from
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  a idea to adoption, you know, in a
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  very complex health system.
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  Right? And we wanna make sure that, you
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  know, we build a durable infrastructure
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  and just, you know, not one off pilots
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  that don't scale.
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  Thank you, Simon, for that great introduction of
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  City of Hope. I'm Nasim,
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  chief AI and analytics officer.
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  I
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  lead,
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  meaningful application of machine learning AI, under Simon's
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  leadership
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  in all areas of patient care,
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  research, precision medicine, and operations.
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  I've been with the company for nine years
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  now, and,
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  and my background is in computer science and
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  machine learning.
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  That's amazing to hear. And, you know, really
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  great to have that experience at City of
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  Hope and then be able to support its
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  growth, which has been, you know, outstanding over
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  the last several years.
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  I'm curious. Could you tell me a little
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  bit more about the most important initiative that
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  you've led in the last year or so?
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  What did you do, and what were the
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  results?
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  Well,
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  I would say that, you know, we have
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  a very strong focus on, governance and our
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  operating model when it comes,
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  to advance the an emerging technology. So,
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  the most in important initiative wasn't just a
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  single tool.
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  It was really establishing the, you know, conditions
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  for AI to scale responsibly,
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  within our organizations.
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  So, and and really focusing
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  on,
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  reframing
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  our governance
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  as an enabler, not a barrier. So, I
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  would dare say as a partner, not a
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  police.
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  So, you know, help clarify the decision rights,
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  you know, embedding the right guardrails,
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  and,
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  really moving governance closer to where the work
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  is actually happening.
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  So this is not a bolt on anymore
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  for us. It's within the structure of our
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  organization.
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  And,
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  you know, we wanna make sure that, we
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  do the right things for,
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  for our folks and really focus on scale
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  and velocity
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  and, really partner with our organization.
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  Nassim, anything you wanna add?
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  Sure. So I,
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  I wanna,
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  add a little bit to the governance piece.
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  We we've been,
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  we've been giving a lot of thought to
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  how do we safely and responsibly
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  apply these technologies, but also balance the speed
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  of innovation.
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  Like Simon said, we have safe and responsible
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  use of AI.
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  We have had a lot of, like, you
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  know, very,
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  tangible exciting initiatives that we've been leading over
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  the past year, like using generative AI for
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  patient onboarding,
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  for clinical trial matching,
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  and and many other things in digital pathology
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  and precision medicine and others.
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  But one of the most important things that
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  I keep thinking about day in day out
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  is and and it ties into governance a
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  little bit and scale and velocity is how
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  do we
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  really orchestrate
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  all of these different AI tools and these
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  days, AI agents
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  that every organization
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  is adopting for point solutions.
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  So
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  we we wanna be, we wanna get ahead
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  of it so that
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  in, like,
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  in a year or so, we don't have,
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  tens, hundreds, thousands of agents running around the
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  organization, each doing their own thing, and they
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  cannot talk to each other.
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  So I think, in terms of governance and
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  also technology,
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  a big top of mind for me is
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  now how do we manage,
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  all these AI agents and tools, not just
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  agents, but AI tools and agents. How do
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  we orchestrate them to work effectively with one
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  another
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  and, and optimize the whole system rather than
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  just one part of, like, a
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  a local optimization of we solve this problem,
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  but then we shift the bottleneck somewhere else,
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  and then we have to solve that other
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  problem.
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  That makes a lot of sense. You know,
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  it's truly fascinating to see all of the
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  different possibilities that are out there with AI,
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  but you're right. Being able to have the
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  governance process and having visibility into everything that's
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  going on, the different agents, and
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  sharing that with the entire organization so you
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  can smartly and effectively,
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  incorporate
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  AI without too much risk coming back to
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  you. So, I think that's critical and so
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  helpful to understand that process that you've taken
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  and really built into,
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  what you're doing at City of Hope. Now
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  looking ahead for the next year or so,
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  where are some of your big priorities and
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  headwinds that you're focused on? What's really top
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  of mind for you?
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  Oh, man.
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  A fantastic question.
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  I think Nasim really hit it. A major
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  priority is, scaling agency across the organization, but
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  responsibly.
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  It's
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  really important for us to, empower our researchers,
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  our clinicians,
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  and our teams,
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  to be able to create and run their
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  own agents. Right? You know, they for them
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  to
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  be trained and,
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  skilled to act with confidence,
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  to,
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  you know, use all of our intelligent tools
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  responsibly,
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  and make decisions closer, to the work. And,
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  you know, one of my mantras at the
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  office here is that, innovation is federated,
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  and, we believe that,
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  this really will help us, make that come
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  true because
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  we have to rethink the decision rights
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  when we scale this agency and not just
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  deploying a basic technology. Right?
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  And the headwind here is, you know, most
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  organizations
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  are built for a centralized permission.
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  Right? And, this work, you know, AI specifically
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  requires distributed responsibility.
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  So how do we
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  shepherd the organization and work together in order
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  to go through that kind of a change
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  management?
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  If it's if it's Simon's priority, then it's
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  my priority. So on on my end,
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  to enable this, one of the biggest thing,
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  this year,
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  is AI, literacy, fluency, education.
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  How do
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  we educate our workforce to
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  work off of a shared knowledge base so
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  that they can have this agency that, Simon
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  is aspiring to? When we started,
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  after the, AI boom,
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  suddenly AI got democratized and everyone
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  with very, like,
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  in a very user friendly fashion could interact
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  with AI, and that was amazing. That raised
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  a lot of awareness about possibilities,
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  but also, I think, exposes
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  us and any other health care organization to
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  a lot of risks. So we had to,
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  hug AI close for some time
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  and started educating, educating, educating so that people
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  know if you're using this AI tool, it's
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  great. It can make you more productive. But
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  when you put something in it, it goes
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  on the cloud. The data is now publicly
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  available.
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  So you don't put PHI into these publicly
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  available tools. You should be using our enterprise
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  instances of
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  of, these AI assistants. So we started,
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  using every tool that we have available to
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  us from from emails that Simon and I
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  send out to formal trainings
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  and certifications, and we're still doing that. So
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  I think that for me,
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  I want to,
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  I want all of our workforce to have
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  that level of, fluency in AIs that we
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  can really
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  give agency to everyone to then build their
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  own agents and don't cause, or or
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  be less prone to causing an unintended harm.
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  So that's AI education top of mind for
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  me.
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  That makes a lot of sense and, you
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  know, it's so critical for the organization. I
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  think for some, it might be an easy
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  leap, and for others, it takes a lot
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  more to really help them understand what the
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  AI is capable of doing and then understand
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  the risks and and being able to act
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  appropriately because of it.
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  And and so I think that's really critical
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  and cool to understand, you know, how you're
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  developing those programs and then spreading it across
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  the organization.
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  And and within that, kind of mindset, what
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  do you think the hardest thing about all
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  of this, that you'll have to do in
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  the coming year will be?
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  The hardest thing,
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  Simon, I'm going to steal your thunder here.
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  The hardest thing has always been and will
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  I I think for the foreseeable future, it
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  will always be change management, adoption,
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  changing the culture so that
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  so that these tools
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  make the intended impact that we're hoping they
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  would make.
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  Bringing,
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  onboarding AI, tools,
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  always requires a lot of changes to people's
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  day to days and workflows, and we're talking
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  about people who are already
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  extremely busy and,
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  and a lot of time set in their
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  own ways.
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  So, I think that's, something that in our,
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  executive leadership team, and enterprise,
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  technology group, we're always thinking about change management
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  and how do we change the mindset and
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  that make that culture shift that AI can
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  be successful. Because I think the technology is
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  there for the most part for a lot
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  of things that we wanna accomplish, but, does
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  it really get adopted and used and make
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  the impact? That's the big question.
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  And, and you've done a great job, Nassim,
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  in in really facilitating the organization because,
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  you know, we really wanna you know, our
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  focus is on ensuring quality, trust, and usability,
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  that key pace as these systems are growing.
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  So and technology is really helping, you know,
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  reduce the cognitive and administrative burden
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  or, for our teams rather than adding to
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  it.
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  Right? And, when you move from a
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  a tech enabled mindset
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  to a tech forward organization,
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  that requires new ways of working, you know,
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  new decision making norms, and a lot of
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  cultural adoptions. And,
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  you know, and and, frankly, success depends on
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  trust,
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  you know, clarity and champion,
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  and the champions across the organization.
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  You know, this is not something you mandate.
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  You gotta work together and then ownership move
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  it forward. And
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  it's been a a really interesting journey for
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  Nassim and I as we, shepherd this through
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  the organization.
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  And that's amazing to hear. And, you know,
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  truly, it sounds like,
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  that move from the tech enabled mindset to
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  the tech forward
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  organization is something that so many health systems
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  and hospitals and health care organizations across the
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  country are are looking to do. And so
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  your framework here in in some of the
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  ways that you're looking at it from the
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  leadership perspective,
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  really is so helpful to understand.
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  I'm curious. Before we wrap up, I wanna
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  talk about growth too. Where do you see
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  some of the best opportunities for organizational growth,
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  especially as you're bringing in more of this
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  education, more of these opportunities,
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  and more,
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  of that
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  tech forward mindset,
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  across the board?
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  You know,
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  for me,
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  it's really focusing on, you know, what I
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  call blended intelligence
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  when we talk about organizational growth,
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  especially in health care,
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  right, to bring the best knowledge
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  to the point of decisioning and letting, you
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  know, human wisdom apply the context values
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  and the judgment
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  at that
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  point. So and, you know, this is where
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  AI,
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  really has the,
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  capability
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  to amplify human,
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  wisdom,
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  right, not to replace it.
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  And that's where we want to be and
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  make sure that we're very responsible,
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  about it.
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  K? And the one last thing is, I'll
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  add, and I'll turn it over to Nassim,
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  is that this is also the opportunity where,
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  as we discussed before,
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  for, innovation to be invisible.
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  Right? So if we are doing the right
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  things for our patients and our providers
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  in a way that,
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  we're allowing them to practice their medicine at
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  the top of their license and our patients
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  to have the best experience,
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  and,
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  we'll take advantage of it. Thanks, Simon. So
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  Simon,
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  hit on the one of the most important
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  aspects of growth, which is enabling people to
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  be,
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  not only more productive, but also enjoy what
• 14:45
  they do day to day and keep, take
• 14:47
  away the mundane,
• 14:49
  repetitive parts of their workflow so that they
• 14:51
  can operate at the top of their lessons.
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  So that's one aspect of growth.
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  Another aspect of growth, at least for City
• 14:57
  of Hope, is patient access.
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  We want to we want more patients to
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  have access to,
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  the world class care and research that we
• 15:06
  provide, and we are using a lot of
• 15:09
  technologies, including AI technologies,
• 15:12
  to make that possible so that in every
• 15:14
  community center,
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  even outside of City of Hope, people can
• 15:17
  have access through our technology
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  to the world class care and research that
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  we provide.
• 15:23
  That's been something that has been top of
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  mind,
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  always for me over the past nine years
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  and and so and finally, technology is there
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  to be able to enable it in a
• 15:33
  very reliable
• 15:35
  fashion. So that's also something that we are
• 15:37
  focusing on.
• 15:39
  I love it. Thank you so much, Nasim
• 15:40
  and Simon, for joining us on the podcast
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  today, and I'm looking forward to seeing you
• 15:44
  both as well at our annual meeting. I
• 15:45
  know you'll be
• 15:47
  doing a session, a fireside chat,
• 15:49
  with one of our editorial leaders just about
• 15:51
  everything we talked about here today and digging
• 15:54
  deeper into some of these areas that are
• 15:56
  so important when you think about technology and
• 15:59
  AI in health care and clinical care as
• 16:01
  well. It's just, incredible to see the opportunities
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  and how you've been able to really maneuver
• 16:06
  around it at City of Hope. So I'm
• 16:07
  looking forward to learning more and seeing you
• 16:09
  in a couple weeks.
• 16:10
  Thank you. Looking forward to it. Same here.
• 16:12
  Thank you so much.