LeanTaaS’ founder and Chief Executive Officer Mohan Giridharadas and Eric Eskioğlu, MD, MBA, Neurosurgeon, then Executive Vice President, Chief Medical & Scientific Officer and Co-Director, Institute of Innovation and Artificial Intelligence, Novant Health came together at the June 2022 Transform Hospital Operations Summit in partnership with Becker’s.
The two leaders discussed how Novant Health has learned to embrace AI to protect patients, increase job satisfaction, and help reduce burnout. The full discussion was originally published on Becker’s Hospital Review.
Mohan Giridharadas: Can you talk a little about your background and how your unique perspective helped drive Novant Health’s AI journey?
Dr. Eric Eskioğlu: I began my career as an aerospace and mechanical engineer in the aviation industry before I embarked on a career in medicine as a neurosurgeon and Chief Medical & Scientific Officer and Co-Director of the Institute of Innovation and AI for Novant Health. When I began my tenure at Novant Health, I actually found I could apply much of my experience in the aviation and aerospace industry to healthcare. Both fields are logistically complex and asset-intensive, with an essential focus on safety and quality, avoiding errors is critical. In the event of an error both industries risk people’s lives.
The fact is, US healthcare is not trending toward avoiding errors. The renowned 1999 To Err is Human report showed that annually 200,000 people died from medical errors and serious safety events. Last year, that number was up to 450,000. That is the equivalent to two big planes full of passengers crashing every day. How much of the public would fly if they saw two planes crashing every day?
We need to learn from all the experience we have had in the aviation industry and automate processes to reduce errors and improve safety and quality. When you go on an airplane today, you do not think about the autopilot being in the background, giving information to the pilot and helping him fly the plane, but the AI-based technology that performs this function is critical for safe passage. I recognize we need to continue applying those same checks and balances to promote safety and quality in healthcare, and that has influenced much of my work in applying AI at Novant Health.
I recently collaborated with my colleague, Chief Digital and Transformation Officer Angela Yochem, to launch Novant Health’s AI journey before the COVID-19 pandemic. About five years ago we began discussing the potential use of AI in our organization, and the concept was initially met by some with fear of the unknown. Fast forward to 2022, and Novant Health is now one of the most innovative health systems in the United States, and we are able to implement, execute, and operationalize AI successfully across our network.
MG: What are some key learnings you would share with other health systems looking to replicate Novant Health’s success with AI?
EE: First, to ensure the AI implementation is productive and worthwhile, it is important to build consensus by meeting healthcare leadership where they are. To this end, I recommend explicitly approaching AI from a safety and quality angle, which are rightful priorities for health system leadership. At Novant Health, we prioritize any AI solution that impacts these measures, a focus that naturally earns support from our CEO, and Board, who value delivering the safest and highest quality care.
Because CFOs ultimately write the check to fund AI initiatives, it is especially important to keep them in the loop. To provide a broader, holistic picture of the benefits from adopting AI, showing a return on innovation may be more effective than just a return on investment. Organizational innovation is messier and less clear-cut than straightforward strategy, and can take time, but the results are equally far reaching and satisfying.
To support this full innovation, when considering new AI initiatives, Novant Health looks for platform solutions which can support our entire system, not just a single market or service within it. Part of that process is validating the initiative with a team of clinicians and team members of Novant Health’s Institute of Innovation and AI. The clinicians’ input and engagement from the beginning ensures the effort will help both themselves, and their patients before it proceeds.
In doing a wide rollout, we have learned to take a phased approach to implement each new AI effort. For instance, when we launched a new AI product with LeanTaaS, we began in a smaller hospital before branching out into a parallel process with our existing systems. This allowed us to constantly gather feedback from staff, nurses, and clinicians, who showed great enthusiasm.
We plan to run parallel processes for three months, but 90% of the time, after 2-3 weeks the involved clinical teams want to immediately discontinue their old processes because the new ones quickly show advanced improvement and greater benefit.
MG: What are some of the most compelling results you’ve seen from the AI program at Novant Health?
EE: One key measurement of the effectiveness of Novant Health’s AI programs is patient satisfaction. Hearing from patients directly is the best way to measure that success. Consumers are used to the immediate convenience from services like banking or retail apps, so providing them with the ability to schedule healthcare appointments using a smartphone is a game changer. Personalized medicine is all about how, where, and when patients want to interact with us therefore, we need to listen and meet their needs. AI also provides a more seamless in-person visit, such as a “waitless” IV infusion experience that has been made possible through LeanTaaS’ iQueue for Infusion Centers.
Patients at Novant Health’s cancer care centers now use their iPhone, look at available times, and pick when they want to go to which chair, and just go without spending extra time in the waiting room. Patients do not pay us to wait, they pay us to treat them. This has become a tremendous patient satisfier and has led to more consistent workflows for staff as patients tend to stick with the appointment, they chose for themselves, on the platform where they order other services in their day-to-day lives.
We also attribute AI to our ability to reduce the backlog of surgical cases due to COVID-19. We were able to swiftly implement LeanTaaS’ AI-based iQueue for Operating Rooms to automate scheduling OR cases for surgeons.
Although the majority of cases are scheduled by the clinics through the cloud-based solution, Novant Health surgeons are able to use their mobile devices to access the tool and select a desired case time with their patient and book open time. This cuts out the arduous process of surgical scheduling that involves faxing, multiple phone calls, and the potential for misinformation and staff burnout. AI-driven scheduling improves both patient and provider satisfaction.
MG: Can you talk further about the issue of staff and clinician burnout at Novant Health and within the industry, and your approach to using AI to mitigate it?
EE: Social fabric of nursing units are shredded to pieces. There are a multitude of reasons for this. We are highly cognizant of physicians and nurses burning out because of best practice alerts and alarms and we think critically about adding more clicks to a physician’s workflow. Novant Health’s philosophy is, “If we are adding something from AI that is one click, we need to take away two clicks. We need to lessen the burden on our nurses and physicians.” Our innovation with AI is allowing us to do that.
Over the years, physicians and nurses have effectively become data entry clerks. At many health systems, in nursing workflows, 50% of staff time is spent on documentation for regulatory reasons. Another 20% is spent on hunting and gathering equipment and medications. If nurses are lucky, they spend 25-30% of their time on clinical calls actually caring for and communicating with patients. Novant Health seeks to increase that 25% clinical time to 50%, 60% or 70%. The upcoming role of AI and automation will be to take away the mundane routine data tasks.
MG: What are your thoughts on the future of AI in healthcare?
EE: I believe healthcare is on the verge of entering a golden age, where supportive AI will be the norm. Today, as I mentioned before, when you go onto a plane you do not think about there being an autopilot. AI is going to be there to protect patients, increase job satisfaction, and health, and reduce burnout. Once AI is fully implemented in healthcare what’s left is key human competence of empathy and judgement. Meaningful work is after all what our nurses and physicians are craving for.
Novant Health is already beginning to bear this future out.
