Finding True Value in AI for Smaller Health Systems

‐

By Eric Wicklund

For small hospitals just trying to keep the doors open, AI is both a blessing and a curse. It can offer a couple of effective and important improvements amid a sea of shiny objects and useless add-ons.

“Those of us at smaller health systems are trying to sort through the hype from vendors and [from] what academic medical centers claim to be doing,” says J.D. Whitlock, CIO at Dayton Children’s Hospital. “Sometimes they’re doing fabulous things. Sometimes they’re just claiming to be doing fabulous things. Sometimes they claim to be doing a fabulous thing which is just some feature in Epic that we have to turn on.”

For Whitlock, the challenge lies in sifting through the promises to find the technology that his 181-bed hospital can both use and afford. Being a part of the Epic universe is certainly helpful, he says, but it’s not a sure-fire recipe for sustainability.

“There’s a handful of things – maybe not even that, maybe a small number of things – that you really need to be doing on top of and outside your EHR and ERP platforms, assuming you’re on the good platforms,” he says.

“Maybe you do need some kind of fancy AI, some custom AI that’s going to go in and help everything, talk to everything,” Whitlock adds. “But for most of us, most of the time the innovation that we need to be doing is just implementing all the new things that are coming from Epic and Workday and not having too much FOMO about or not wasting resources that we don’t have on fancy new things that might or might not work.”

Whitlock says he’s  looking closely at AI tools that improve revenue cycle management, an area of high opportunity for Dayton Children’s. But once again, the benefits have to outweigh the costs and challenges of implementation.

It’s a real battle deciding on what you want vs. what you need. Whitlock says he’s fascinated by the pace of Epic’s AI ambitions, and eager to see just how each new tool might help the hospital improve its footing in a perilous environment.

But then he’ll look at the cost, or the disruption that embracing a new technology might create. That includes getting buy-in from sometimes (OK, often) hesitant clinicians.

“That [new AI tool] is great, except many of us can barely keep up with the new features coming from Epic before that,” he says.

One tool that Dayton Children’s is embracing is ambient AI. The hospital became one of the first pediatric hospitals in the country to use the technology when it partnered with Abridge earlier this year to launch the tool.

“You need to be doing ambient or else you won’t be able to recruit physicians in a year,” Whitlock says.

And while he admits the value coming from ambient AI is considered “soft ROI,” there’s more to be said for the technology in the long run, especially for small health systems who struggle to maintain a good workforce. Happy doctors won’t leave as quickly, Whitlock notes, and that translates to reduced turnover rates and less hiring and training expenses.

That also means dealing with clinical expectations for AI. Whitlock says it’s a challenge to secure buy-in for a technology that some doctors and nurses think will replace them – especially when labor unions get involved. That’s why it’s crucial to have conversations with clinicians up front about AI as an assistive or augmentative technology, rather than artificial intelligence.

That goes with patient education as well. Maintaining patient engagement and satisfaction is a critical strategy for small hospitals. Whitlock says they’re careful to point out that AI is used to help clinicians, and that their doctors and nurses aren’t using the technology as a replacement for critical thinking.

“In order to deliver the best care to you and your family, we may use [or] are using some artificial intelligence,” patients are told. “But don’t worry: It’s not diagnosing and training you. Your doctor’s still doing that. We’re just using it to augment our clinicians.”

“We think our doctors are smart enough not to do that,” he says.

It’s (Not) a Kid’s World

Whitlock’s innovation strategy is similar to that of pediatric hospitals across the country: Find the technology that fits into the very specialized pediatric care space. Seeing as how so much of the innovation and technology space is geared towards adults, that can be a challenge.

For example, he needs technology that can accurately track, schedule and capture date from well-child visits.

“It’s in every quality measure,” he notes, and has to be documented properly. So he’ll talk to a few vendors about their products and ROI, then check with other children’s hospitals around the country to see what they’re using. If that doesn’t pan out, he may have to talk to a vendor who can jury-rig technology to fit the specific needs of Dayton Children’s.

“That’s not easy,” he says.

The key, Whitlock says, is creating a clear pathway for technology and innovation and staying in it. Listen to vendors, then check with other hospitals using that technology to make sure the promises hold up. And don’t get caught up in embracing AI just because everyone else is using it.

“Small health systems don’t have the resources to chase after gold stars and turn things on that we are not actually going to use,” he says. “We have to be judicious about what really fits for our health system that we’re really going to use and turn those things on.”

Eric Wicklund is the senior editor for technology at HealthLeaders.