Latest / Becker’s Healthcare Podcast / Designing AI with Nurses to Reduce Burnout and Improve Care Delivery
Transcript
- 0:00Welcome back to the Becker's Healthcare podcast. I'm
- 0:02Molly Gamble, Becker's, and we're recording this episode
- 0:04during National Nurses Week, a week dedicated to
- 0:06recognizing the invaluable contributions nurses make in health
- 0:10care and in our lives while also acknowledging
- 0:12the very real challenges they face every day.
- 0:15In light of that, we're having a real
- 0:16conversation today about what it looks like when
- 0:18nurses are the ones helping design AI and
- 0:21what it takes for that technology to be
- 0:22trusted at the bedside.
- 0:24I'm joined by two people leading that work.
- 0:26Jennifer Gaum Rushman is assistant vice president of
- 0:29digital health at Cincinnati Children's Hospital Medical Center,
- 0:32and Amy McCarthy is chief nursing officer at
- 0:34Hippocratic
- 0:35AI.
- 0:36Jen, Amy, welcome, and thank you for being
- 0:38here. Thank you, Molly. Thank you for having
- 0:40Thanks for having me.
- 0:42Jen, I'm gonna turn to you first. You
- 0:44recently collaborated with Hippocratic AI on their new
- 0:48nurse facing application, and we're gonna get to
- 0:50that. But first, I I wanted to look
- 0:52a little bit further upstream.
- 0:54From your seat at Cincinnati Children's. Why is
- 0:56it so important to bring innovation
- 0:58into nursing right now?
- 1:00What what are you seeing day to day,
- 1:02and how do you see AI fitting in?
- 1:05Yeah, Molly. I think that's such an important
- 1:06question because, you know, one of the things
- 1:08that we're seeing and I know that people
- 1:10are seeing across health care I mean, even
- 1:12before the pandemic,
- 1:13there was lots of
- 1:15concern about the,
- 1:17staffing and nurse availability
- 1:19and and and since that,
- 1:21time, you know, lots of folks have,
- 1:24have retired from the profession. They've given it
- 1:26their all. And so we see, you know,
- 1:28both, you know, sometimes a challenge with nursing
- 1:31staffing
- 1:32as well as a lot of young and
- 1:33new nurses in the field. And so when
- 1:35we think about
- 1:37innovating with them,
- 1:38you know, being able to provide them some
- 1:40tools so that they can operate at the
- 1:43top of their licensure, but also really thinking
- 1:46about how do they do what they
- 1:48have been passionate about and what they desire
- 1:50to do at the bedside, provide that personalized,
- 1:53very humanistic
- 1:54part of the care, and then how can
- 1:56we leverage some of these tools like AI
- 1:59to reduce that burden for them and enable
- 2:01them to really perform at that highest level,
- 2:05knowing that there there's a finite number of
- 2:07nurses that we're gonna be able to have
- 2:09at every patient's bedside, and we wanna make
- 2:11sure we give them the tools to do
- 2:12that job to the best of their ability.
- 2:15Mhmm.
- 2:16Amy, this is really the perfect handoff we
- 2:18just heard from Jen about some of the
- 2:20the effects of of the pandemic that are
- 2:21still lingering in hospitals and health systems among
- 2:24nursing teams.
- 2:25Amy, you and I, we met at Becker's
- 2:27annual meeting just a few weeks ago, and
- 2:30that's where this nurse co pilot from Hippocratic
- 2:32AI first came onto our radar.
- 2:35Flipped it out a little bit. Can you
- 2:36take us back to the beginning? Why did
- 2:37Hippocratic
- 2:38launch this product, and then how did you
- 2:40go about developing it?
- 2:42Yeah. Absolutely. It's a great question. So,
- 2:45you know, when we were thinking about our
- 2:47AI agents, traditionally,
- 2:48they have met patients where they are outside
- 2:51of the hospital space, but it was very
- 2:53important to us as we were designing to
- 2:55think about how can AI agents be a
- 2:58part of the entire care continuum.
- 3:00I have been a nurse for over fourteen
- 3:02years. I came directly from the inpatient space,
- 3:05and so that's an area that I'm really
- 3:06passionate about. I've seen firsthand,
- 3:09a lot of the the administrative tasks and
- 3:11just a cognitive overload that nurses are facing
- 3:14on a day to day basis. So it
- 3:15really was very much a passion project for
- 3:17me to truly sit down and think about
- 3:19how can AI agents be used by nurses?
- 3:21How can we start to use this to
- 3:23redesign their workflow? And that's where Nurse Copilot
- 3:26really came into be. We wanted it to
- 3:28be a Copilot,
- 3:30an augmentation tool to allow the nurse, as
- 3:32Jen mentioned, to really be able to be
- 3:35present, to be focused on the patient in
- 3:37front of them, and to not get caught
- 3:38up in the day to day of just
- 3:40administrative tasks. And so it was very important
- 3:43to me too, as someone who's worked in
- 3:45the clinical space who has had technology handed,
- 3:48to her that really didn't make sense in
- 3:50workflows a lot of times,
- 3:52to to sit down with nurses, to sit
- 3:54down with clinicians from the very beginning and
- 3:56to say, so here's the product that we're
- 3:58thinking about. Tell me, does this work? Does
- 4:01it not? How do we codesign this together?
- 4:04And, you know, the relationship with Cincinnati Children's
- 4:07and several of our co development partners has
- 4:08been just a fantastic example of this, is
- 4:11sitting down and having my team of engineers
- 4:14and researchers sit down with the nursing
- 4:17team, with the clinicians at Cincinnati Children's and
- 4:19say, you know, here's here's how the workflow
- 4:22is today. Here's how we can use AI
- 4:24agents,
- 4:25in the day to day to really improve
- 4:27the workflow to give nurses more of a
- 4:29chance to be present,
- 4:31and and think about how this can help
- 4:33them with tasks around admissions, discharge preparation, patient
- 4:36education, even family education.
- 4:39And it's been it's been really neat to
- 4:40see the results of that and to see
- 4:42how proud and excited the nursing team is
- 4:45of the work that they've done, and they
- 4:46truly become champions of this.
- 4:49Mhmm.
- 4:49Amy, you just touched on what can so
- 4:51often happen where the technology the people developing
- 4:54the technology underestimate
- 4:55nurses' workflows
- 4:57and think something that's gonna be easy to
- 4:58get into the mix is actually, to them,
- 5:01one more thing to either click or document
- 5:03or another burden to account for. It sounds
- 5:05like Hippocratic AI took the exact opposite approach.
- 5:09Jan, I'm gonna turn back to you here.
- 5:11You know, Cincinnati Children's is a special place.
- 5:14You you obviously have pediatric and children patients
- 5:16and then also, like Amy just mentioned, the
- 5:19families.
- 5:20Let's talk a little bit about the safety
- 5:22and empathy
- 5:23values of technology,
- 5:25how Nurse Copilot was built.
- 5:28If you can help us appreciate this, Jen,
- 5:29from the clinical side. These two things in
- 5:32nursing, empathy and safety are are paramount,
- 5:35especially in pediatrics. What what does it actually
- 5:38take for a nurse to trust AI enough
- 5:41when it comes to safety and empathy to
- 5:43really begin to integrate into their their care
- 5:46in front of a patient?
- 5:48Yeah. Molly, you're you're absolutely right. Right? You
- 5:50know, safety is paramount. We we that's sort
- 5:53of always first in in our mind.
- 5:55And it was it's been really a great
- 5:58journey with our frontline nursing and the co
- 6:00development of this. I feel like it was
- 6:02really a turning point moment when they could
- 6:04start to hear the AI agent.
- 6:07And then what they were able to do
- 6:09is kind of record their own conversations about
- 6:11how would we have this conversation about sort
- 6:14of hospital basic education, etcetera,
- 6:16and then hear that come to life,
- 6:19in a way that they felt felt like
- 6:20it was not only very safe.
- 6:23We could make changes, you know, the
- 6:25Hippocratic ai and others wanted their feedback, wanted
- 6:28them to say, I don't like how this
- 6:30is being said, or I don't like how
- 6:31this is being done, but also that it
- 6:33felt very humanistic. We had one patient during
- 6:36our first week of go live that the
- 6:38the parent had the it on speaker phone.
- 6:40And at the end of the call, the
- 6:41patient was like, I love you.
- 6:43And, you know, the AI kind of said,
- 6:45well, I'm not I'm a I'm an AI.
- 6:46I'm not a person, but it was, it
- 6:48it is a very humanistic experience. I think,
- 6:51really, for our nurses, they had to hear
- 6:53that, and they had to be able to
- 6:54hear how their feedback could be incorporated,
- 6:56you know, almost immediately. And that,
- 6:59really builds that trust. And without them trusting
- 7:01the tool, they're not gonna talk about it
- 7:03with patients and families in a way that
- 7:05our patients and families trust the tool. And
- 7:07so that mutual,
- 7:09trust is really important because then when the
- 7:10nurses are having those conversations,
- 7:12they're doing that in a way that the
- 7:14family says, okay. I get it. She trusts
- 7:16this tool or he trusts this tool, so
- 7:18I'm gonna take that call. I'm gonna engage.
- 7:20And so I think it's been really important,
- 7:22and paramount to the design. I love that
- 7:25detail of of signing off with I love
- 7:27you, and the agent correcting or, you know,
- 7:30reminding what it actually is. But but, Jen,
- 7:32I mean, what you just described, that is
- 7:34something that health systems nurses and digital leaders
- 7:38probably don't get asked enough to weigh in
- 7:40on when it comes to feedback.
- 7:42What changes would you like to see made?
- 7:45More broadly, what was it like to be
- 7:47on the receiving end of those invitations to
- 7:49weigh in? You're not just being treated like
- 7:52a customer or end user, but you're actually
- 7:53sitting at the table with your nursing leaders
- 7:56and nurses
- 7:57while the product is being designed.
- 8:00Yeah. I mean, I think that's really been
- 8:02part of what's been game changing about this
- 8:04for us. Not only
- 8:06sitting at the table, we, you know, we
- 8:07had these sessions with frontline nurses where they
- 8:09were talking about real problems. I mean, one
- 8:11of the examples and one of the reasons
- 8:13we have a a call today for for
- 8:15just to check-in was that they were talking
- 8:17about families
- 8:18where English isn't their first language and the
- 8:20challenge of always having an interpreter for for
- 8:23questions like where can mom and dad get
- 8:25a meal,
- 8:26you know, and those types of things. And
- 8:27so the the nurses,
- 8:29were able to kind of bring to life
- 8:32what are the real challenges that I have
- 8:33that I worry about that keep me up
- 8:35at night with my patients and families.
- 8:37And then
- 8:39being able to to see a tool designed
- 8:41to kind of meet those needs was was,
- 8:43I think, really
- 8:45important,
- 8:45for them and and for them to feel
- 8:48like,
- 8:48again, it wasn't something that was being done
- 8:50to them, but they were being being involved
- 8:53in the design of it and being able
- 8:55to make changes to it. Right? It wasn't
- 8:57just lip service to the design of it.
- 8:59It was really, what are we gonna do?
- 9:00What are we gonna talk about? How all
- 9:02of that is gonna happen? What was,
- 9:04was really influenced by the nurses. It also
- 9:06really helps in adoption. Right? As a digital
- 9:09health professional,
- 9:11that's always the the the barrier. Right? We
- 9:13can build it, but will they come? And
- 9:15so, you know, I really am hopeful as
- 9:17we continue to roll this out. We're seeing,
- 9:19you know, positive trends with adoption from those
- 9:22nurses because they feel like it's theirs. They
- 9:23they developed it.
- 9:25Mhmm. Mhmm. Amy, we're talking about the the
- 9:28design of Nurse Copilot and the stakeholders part
- 9:31in that as Jen just helped us better
- 9:32understand. Let's go a little bit more under
- 9:35the hood if we can for a minute.
- 9:36We we understand why Nurse Nurse Copilot exists,
- 9:39what it's like for nurses to use it.
- 9:41Can you, Amy, talk more about the engine
- 9:43behind it? How does Hippocratic AI ensure safety
- 9:47in its technology?
- 9:48What are the the systems and the standards
- 9:50behind a product like this?
- 9:52Yeah. Absolutely.
- 9:54It's a it's a great question. You know,
- 9:55we recently
- 9:56released our our latest model, Polaris five point
- 9:59o, and it's a continuation
- 10:01of our Constellation model and our commitment to
- 10:03safety. We knew as a company that if
- 10:06we were going to have AI agents that
- 10:08we're going to be patient facing,
- 10:09that they needed to be held to the
- 10:11utmost standard,
- 10:13you know, just like myself as a nurse.
- 10:15Right?
- 10:17I I have a very high commitment to
- 10:19safety.
- 10:20My license is dependent on that. And so,
- 10:22you know, we do a
- 10:25very rigorous amount of testing
- 10:27when it comes to these AI agents, and
- 10:29and the continuation of our our benchmarks and
- 10:32and our, and and our new model are
- 10:34really showcasing that. But to kinda walk you
- 10:36through our processes,
- 10:38every AI agent when we create that, we
- 10:40do dual testing. We have our our partners,
- 10:43just like, here with Nurse Copilot.
- 10:46Cincinnati Children's and the nurses were a very
- 10:48big part of testing the AI agent. We
- 10:50also do a a huge amount of testing
- 10:52on our end. I have a team of
- 10:53nurses,
- 10:54who work for Hippocratic who do,
- 10:56anywhere from 200 to 500 test calls of
- 10:59the agent before it goes live. I have
- 11:01a team of nurses who even after the
- 11:04agent is having patient facing conversations, they are
- 11:07reviewing
- 11:08the first 1,000 calls, looking for things like
- 11:11clinical and technical errors, and those things are
- 11:13reviewed every day. And even after those first
- 11:161,000 calls,
- 11:18we continue to monitor all of our use
- 11:20cases across the board because we know that
- 11:22there's no room for error. There's no room
- 11:24for regression of this model. And so we
- 11:26constantly, as a clinical team, have to keep
- 11:28our eye,
- 11:29on these conversations,
- 11:31ensuring that they are having safely, that they
- 11:33are are achieving the goals that our partners
- 11:35are looking for,
- 11:37and and that we're continuing to promote this
- 11:39culture of excellence. I mean, the model itself
- 11:41has been tested by over 7,500
- 11:43nurses across the country who are doing continuous
- 11:46calls. And you might ask, you know, why
- 11:48why nurses? Why are nurses being asked to
- 11:50do this? Well, I I will tell you
- 11:52as as a nurse myself, we know so
- 11:54many of the edge cases. And so I
- 11:56often joke with my nursing colleagues,
- 11:58try to try to break the system. Try
- 12:00to throw all of those edge cases out
- 12:02there to make sure that at the end
- 12:03of the day, no matter what a patient
- 12:05says or throws out at the agent,
- 12:08that we are prepared to handle that conversation
- 12:10in a safe and compassionate manner.
- 12:13And, you know, you see the results of
- 12:14that today. In our model, we have had
- 12:17no serious safety events. We continue to have
- 12:20a 99.9,
- 12:22you know, just safety,
- 12:24rating,
- 12:25across the board. And so, it's it's been
- 12:27a really amazing opportunity to collaborate with nurses
- 12:29at Cincinnati Children's, but also across the country
- 12:32to ensure that this model is safe for
- 12:33patient care.
- 12:35I I love the leadership and the rigor
- 12:37and the commitment to safety behind the challenge
- 12:39of to 7,500
- 12:41nurses to to break the model, Amy. I
- 12:43I think that just that says a lot
- 12:44about how you approach this in in development.
- 12:48Let's in the spirit of National Nurses Week,
- 12:50you both work with nurses in in different
- 12:53lanes, if you will. You're you're close to
- 12:55this work, and I'm so appreciative of the
- 12:57chance to get closer to it through this
- 12:58conversation with you. Let's close out with a
- 13:01forward looking question from both of you as
- 13:03if we sit here
- 13:04with the technology available to us today. If
- 13:06you will look out the next five, ten
- 13:08years even, what do you see the future
- 13:10of nursing looking like? What should our listeners
- 13:13be paying attention to when it comes to
- 13:15AI innovation?
- 13:16Jenna, I'll turn to you first here.
- 13:18Sure. It's funny. I was just in a
- 13:20meeting this morning where, our CEO said if
- 13:22somebody tries to tell us what it's gonna
- 13:23look like in five years, they they're probably
- 13:25making it up. So I will just make
- 13:27it up. But, you know, for me, I
- 13:28think, when we think about,
- 13:30health care and the future of nursing, especially
- 13:33with AI, it's it's gonna be getting past
- 13:35the trust hurdle. Right?
- 13:37For patients and families, we had one of
- 13:39our families that's kind of peering in as
- 13:41we were,
- 13:42filming some introductory videos and things, and what
- 13:45are you guys doing in there? And I
- 13:46don't know if I wanna talk to AI.
- 13:48And then when we explained it to him,
- 13:50he's down the hall five minutes later telling
- 13:52the nurses, like, oh, they're trying to help
- 13:53you out. They're making it easier, you know,
- 13:55for me to ask questions and not bother
- 13:57you all the time. And so I really
- 13:59think when we think about that nursing profession
- 14:02That is a finite resource and it's so
- 14:04invaluable
- 14:05to our patients and families, but we have
- 14:08to be able to
- 14:09Remove some of the tasks that are constantly
- 14:13layered
- 14:14on to our nurses,
- 14:16and allow
- 14:17not only for them to have more time
- 14:19and space,
- 14:21to do, you know, the higher levels nursing
- 14:23skill work, But, also, I think it's a
- 14:25better patient and family experience
- 14:27at times where we think about, I can
- 14:29serve up information. Maybe it's educational content. Maybe
- 14:33it's, you know, reminders. Maybe it's answering a
- 14:35question that they've already answered for me three
- 14:37times, but on my schedule and my timeline.
- 14:40And so I think that the future of
- 14:42nursing is gonna look very different with AI,
- 14:44but we're gonna have to continue to involve
- 14:46the frontline team and our patients and families
- 14:49in that design where that trust factor is
- 14:51really just gonna impact adoption. But, I mean,
- 14:53I think in in lots of ways, it's
- 14:55gonna enable us to take better care of
- 14:58our patients and our families
- 14:59and allow our nurses to leave at the
- 15:01end of their shift. I know Amy says
- 15:03that sometimes I'm always worried about what I
- 15:04didn't do, but feeling like I did it
- 15:06and I have support,
- 15:08if my family has additional questions and concerns
- 15:11after I'm gone. Right? And so I think
- 15:13that's how we're really gonna see AI making
- 15:16an impact for nurses. We need to keep
- 15:18the human in the loop. They need to
- 15:20bring that expertise,
- 15:21but we can help to make sure they
- 15:22don't forget things. They don't you know, we
- 15:24can reinforce information. I think all of that's
- 15:26gonna be ways that we're leveraging AI in
- 15:28the nursing space.
- 15:30Mhmm. Thank you, John. And I don't disagree
- 15:33with the five year,
- 15:34remark. So, Amy, same question to you. Only
- 15:37this time, feel free to edit the time
- 15:39frame to whatever you're comfortable speaking to. We're
- 15:41talking about the future of nursing and how
- 15:43you see AI innovation
- 15:45informing that, changing that, and influencing it.
- 15:49Yeah. It's you know, I think it's an
- 15:50incredible time in nursing. It's a hard time
- 15:53nursing. You know, nurses will often say, you
- 15:55know, they they don't necessarily enjoy change. But
- 15:58when I'm speaking to nurses across the country,
- 16:00you know, I'm very quick to say AI
- 16:01is going to move faster than every anything
- 16:03we've ever seen before. And that's an important
- 16:06thing to know. How do we lean into
- 16:07this conversation? How do we make sure that
- 16:09we're at the table,
- 16:11you know, as we're kind of redesigning
- 16:13what nursing and health care looks like? And
- 16:15that's what I'm most excited about, to see.
- 16:18I do think, to Jen's point, it's hard
- 16:20to think about what this looks like in
- 16:22five to ten years. But what we do
- 16:24know will be constant is that AI is
- 16:26going to be a part of our workflows
- 16:29in the health care space and and even
- 16:30more so in the inpatient space, which traditionally
- 16:33has been kind of, set aside. There there
- 16:36hasn't necessarily been a lot of technological advancements
- 16:39in the inpatient space because it is hard
- 16:41to solve for, but it's a very necessary
- 16:43problem to solve for because I will tell
- 16:45you we are seeing nurses leave the profession
- 16:47in droves due to burnout, due to moral
- 16:50injury. And so how do we start to
- 16:52create an environment that nurses want to be
- 16:54a part of? I like to say, you
- 16:56know, how do we bring joy back to
- 16:58the profession? How do we create an environment
- 16:59where they can thrive in? And so, you
- 17:02know, with with products like ours and and
- 17:04even just exploring the entire AI space, I
- 17:06think we're in this the midst of a
- 17:08kind of a a a renaissance here,
- 17:11figuring out what the smart room of the
- 17:12future will look like. You know, I see
- 17:15the nurse truly as the leader in a
- 17:17lot of just the day to day care.
- 17:19They're they're typically kind of the air traffic
- 17:21controller, letting everyone know what's going on with
- 17:23the patient, what resources are needed. My hope
- 17:26is is that, you know, over the next
- 17:27couple years, we equip nurses with the tools
- 17:30needed to do this job more effectively so
- 17:32that they don't leave their twelve hour shifts
- 17:34thinking, man, I did not get to everything
- 17:36I needed to get to today. I just
- 17:38I didn't feel like I helped my patients
- 17:40enough. That is,
- 17:41you know, that's that's as someone who's felt
- 17:43that experience,
- 17:45it's it's very demoralizing. And so I hope
- 17:48that that we can use this technology and
- 17:50really codesign alongside
- 17:51our our bedside nurses to say, how do
- 17:54we use this in a way that is
- 17:56just very impactful, very intentional, makes sense in
- 17:59workflow. I think that's something that's so important.
- 18:01It makes sense in the workflow. It makes
- 18:02sense in in what the nurse is doing
- 18:05and truly designed for a space that, one,
- 18:07is gonna deliver better patient care, but also
- 18:10allow nurses to truly feel like they're they're
- 18:12able to sit with their patients. They're able
- 18:13to have this experience, build that rapport, and
- 18:17truly be able to deliver the patient experience
- 18:19we all want to at the end of
- 18:20the day.
- 18:22So well said. Jen, Amy, I just wanna
- 18:24thank you both. This was exactly the conversation
- 18:27I had hoped for during nurses' week, not
- 18:29just celebrating nurses, but listening to them, understanding
- 18:32them, and and really building for what they
- 18:34need.
- 18:35To every nurse listening, thank you. We see
- 18:37you this week and every other week. So
- 18:39thank you very much, and happy national nurses
- 18:41week to you. To our listeners, to learn
- 18:43more about Cincinnati Children's Hippocratic AI or Nurse
- 18:47Copilot, please check out the show notes. And
- 18:49as always, you can tune in to more
- 18:50podcasts from Becker's by visiting our podcast page
- 18:54at beckershospitalreview.com.
- 18:56Thanks for listening.