The World Medical Innovation Forum brought clinical innovators and executives from Somerville, Mass.-based Mass General Brigham together with investors and tech company leaders Sept. 23-25 near Boston.
While the event also touched on the latest in biotech and pharma, here are seven digital innovation themes from the conference, as reported on by Becker's:
1. Generative AI is still the great hope. "The most exciting thing right now is clearly generative AI," Mass General Brigham Chief Medical Information Officer Rebecca Mishuris, MD, told Becker's. Its adoption over the last two years is "light years ahead of any technology that's been implemented in healthcare."
The technology is a big part of the ambient clinical documentation wave that is taking over medicine, but generative AI is also being tested at Mass General Brigham for routing incoming patient phone calls and translating patient-facing materials to make them more understandable, she said.
Generative AI will have to become more consistent — it often gives different answers every time you ask it a question — to gain more widespread use in healthcare, she said.
Mass General Brigham has also developed a pathology chatbot, PathChat, but the hope is for generative AI to be able to write pathology reports and come to its own conclusions, said Faisal Mahmood, PhD, an associate professor at Boston-based Brigham and Women's Hospital, during a panel.
Even nonproviders were excited about artificial intelligence's potential. "Biology and technology are colliding to create synergistic effects," Pfizer CEO Albert Bourla, PhD, said at a panel. But AI will require better computing power and data-sharing to reach its promise, he said.
David Blumenthal, MD, professor of the practice of public health and health policy at Boston-based Harvard TH.. Chan School of Public Health, argued at a session that generative AI in healthcare needs scientific standards and a baseline for transparency to ensure tech companies aren't using the health data for advertising.
"The foundational knowledge we need to create trust in this technology does not exist," he said.
The tech will need to be supervised, like medical residents, and continuously monitored, he added. Clinicians, unlike AI, will also remain legally liable for their care.
Health systems will have to balance protecting patient data while allowing AI to use that information to learn and get better, Dr. Mishuris said.
Still, the hopes for the technology are high — and ambitious. Christopher Longhurst, MD, chief clinical and innovation officer of UC San Diego Health, predicted at a panel that in seven to 10 years there would be a large language model licensed to practice medicine. It's a technology that interests leaders across the health system C-suite — from the CIO to the chief medical officer to the CFO — for its ability to enhance medicine and automate administrative functions.
UC San Diego Health's implementation of generative AI to draft MyChart responses hasn't reduced the time spent answering messages for providers, he said — more importantly, it's eased burnout.
"Healthcare is moving faster than any other industry in adopting AI," said Shiv Rao, MD, co-founder and CEO of ambient AI startup Abridge and a former executive at Pittsburgh-based UPMC.
Jane Moran, chief information and digital officer of Mass General Brigham, told Becker's she is working on enhancing some of the "boring stuff" in IT — like network infrastructure — that will position the health system to adopt digital innovations like AI for years to come.
AI can also have public health benefits, by determining which patients should get in fastest for diagnostics and treatments, said Kevin Mahoney, CEO of Philadelphia-based University of Pennsylvania Health System, at a panel.
2. Ambient clinical documentation is still all the rage. Several hundred providers at Mass General Brigham — from primary care offices to the emergency departments — have adopted ambient AI, where a smartphone app records patient encounters then drafts a note for the EHR, with plans to expand it to a few thousand more with additional funding.
Thus far, the technology has cut burnout by 40%, according to Dr. Mishuris.
"There's no other intervention … that reduces burnout like that," she told Becker's.
Two-thirds of providers also reported it would cause them to stay in the practice of medicine, she said.
She compared AI to air conditioning — when it's set properly, you're not even aware it's on.
Mass General Brigham Chief Technology Officer Nallan Sriraman also told Becker's that ambient clinical documentation is the digital innovation making the most difference right now in healthcare.
Ninety-five percent of providers who were offered the technology at the health system took advantage of it, Mass General Brigham President and CEO Anne Klibanski, MD, said at a panel. "When have we ever had anything with a 95% adoption?" she asked.
Still, Dr. Longhurst of UC San Diego Health called the technology a "Band-Aid." He said the average physician note in the U.S. is about 4,000 characters, compared to 800 in other countries. Why? To satisfy billing requirements.
As providers institute AI for prior authorizations, payers will employ the technology for denials. "We're getting into an escalating war of AI," he said. "We can't lose sight of fixing the fundamental problems in our healthcare system."
But AI can do things that humans can't, like scanning tens of thousands of chest X-rays to find things the human physicians weren't looking for, Dr. Longhurst said. "There are a lot of opportunities when the incentives are aligned."
3. "Hospital at home" expands. Mass General Brigham now has the largest hospital-at-home program in the country, with a capacity to treat 70 patients at a time. The care model uses technology and in-home visits from nurses and other providers to treat acutely ill patients with conditions like COPD or congestive heart failure at home.
Mass General Brigham Chief Integration Officer O'Neill Britton, MD, said during a panel that "home hospital" has grown so fast because it's a "win-win": for patients, who typically prefer being cared for at home, and for providers, who need help with capacity issues at hospitals. Just that day, he said, Mass General Brigham had 185 patients in the emergency department without a bed. The health system believes about 10% of acute care patients — about 200 to 300 a day — could be cared for at home if the program can scale.
Researchers from the health system have also found that costs are lower with the care model.
4. The biggest health systems continue to partner on tech. Leaders from Microsoft, Best Buy Health, Google Cloud, Epic, Meta and Abridge attended or spoke at the event, highlighting their collaborations with health systems like Mass General Brigham.
"Google's not going to get into the medical practice. Google's not going to buy an EHR," William Morris, MD, chief medical information officer of Google Cloud, said at a panel.
Mass General Brigham, like several other health systems, uses technology from Best Buy Health for "hospital at home." "Technology is our expertise," Best Buy Health COO Chemu Lang'at said during a session. "Healthcare is fragmented. The technology doesn't always connect."
5. Technology can improve health equity. Mass General Brigham asks patients about their social determinants of health on their MyChart patient portal or on tablets at visits, Dr. Mishuris said at a panel. Health equity leaders educate the system's digital staff of about 1,700 employees about the importance of equity in their work.
The health system has employees text or call patients in their own languages with medical reminders, said Claire-Cecile Pierre, MD, vice president of community health programs at Mass General Brigham, during the talk. She said Mass General Brigham also plans to launch geolocating for its mobile healthcare vans to let patients know which neighborhoods they're in.
Mass General Brigham has used data to analyze wastewater surveillance to predict COVID-19 treatment need during the pandemic and for where to locate its mobile addiction services, said Elsie Taveras, MD, chief community health and health equity officer at Mass General Brigham, at the panel.
6. A lot of innovation happens at health systems. The forum started Sept. 23 with 14 five-minute pitches from Mass General Brigham inventors looking for funding to advance their technologies — from a computer chip for paralyzed patients that allows them to "talk" or "type" with their brains to AI that evaluates breast cancer to a medical "holodeck" straight out of "Star Trek" to a digital health app for rheumatology patients.
It showed the breadth of innovation happening at Mass General Brigham, which at $2.4 billion, gets more academic research funding than any other health system.
The forum, which in its 10th year had its largest-ever attendance of about 2,000 people, represents "innovation at scale," Mass General Brigham Chief Innovation Officer Chris Coburn told Becker's.
7. Health systems, conversely, need innovation. "Academic healthcare centers are threatened in a way they've never been threatened before," Dr. Klibanski said at a panel, citing financial challenges.
"We have to partner more broadly. We have to get out of the mindset of we do everything ourselves," she said. "And adopt new technology in a very different way. We have invested very heavily into moving into the digital world."
Rod Hochman, MD, president and CEO of Renton, Wash.-based Providence, said at the session that hiring leaders from tech companies like Amazon and Microsoft "really changed our culture." On the other hand, the health system bundled its data with peer organizations through a collective called Truveta rather than handing it over to Big Tech. "Folks like us know how to use it for good, not evil," he said.