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Our Take: Feature: Recent health system partnerships in AI technology

Oct 02, 2023
Mercy-Microsoft Collaboration

St. Louis-based Mercy is among the latest health systems to establish or expand upon partnerships with technology companies to explore and test the use of artificial intelligence in the various capacities. 

While many have focused their initial efforts on the use of generative AI for clinical documentation, the recently announced collaboration between Mercy and Microsoft intends to go further. 

“With Microsoft, we are exploring more than four dozen uses of AI and will launch multiple new AI use cases by the middle of next year to transform care and experiences for patients and co-workers,” said Joe Kelly, Mercy’s executive vice president of transformation. 

Using Microsoft’s Azure OpenAI Service, Mercy has immediate plans to apply generative AI for incoming patient calls to schedule appointments. According to the announcement, the AI solution will also provide recommendations during the calls for other follow-up actions, decreasing the need for subsequent calls. 

Mercy will also use generative AI-assisted communication to provide responses to patients’ inquiries in conversational language. The idea is to help patients better understand their lab results and have more informed discussions with their provider.   

Eventually, Mercy plans to use AI to develop data insights that will be useful in reducing unnecessary patient days in the hospital. 

Ochsner, Microsoft, and Epic

A couple of weeks ago, New Orleans-based Ochsner Health said it was launching a pilot program that uses Microsoft’s Azure OpenAI Service to create “simple messages” in response to requests sent through the MyOchsner patient portal. The health system said more than 4 million medical advice requests were sent to physicians through the patient portal last year, Healthcare Dive reported.

The pilot program will test a new Epic feature that drafts responses to routine patient requests, Ochsner explained, noting that the messages are “unrelated to diagnoses or clinical judgments.” Clinicians review the responses before they are sent to patients.  

Microsoft also entered into a partnership with Duke Health in August. Their collaboration will use Azure OpenAI Service “to redefine health care experiences for providers and patients.” Microsoft will provide Duke Health with training and a secure cloud environment, which the health system will use “to streamline clinical care, promote health equity, and further advancements in both research and education.”

GE HealthCare, Google, and Nuance Communications

In mid-September, Rochester, Minn.-based Mayo Clinic entered into a strategic collaboration with GE HealthCare to advance medical imaging and theranostics. As part of their collaboration, they will use AI-powered applications to accelerate the development of advanced magnetic resonance technologies and techniques. They will also seek to improve the patient imaging experience by using “multimodal” data, AI, and digital health platforms to “streamline clinical operations and support more personalized diagnosis and therapy.”

And in late August, Nashville, Tenn.-based HCA Healthcare announced a new collaboration with Google Cloud that will focus on the use of generative AI to improve workflows. 

HCA launched a pilot program in February using Google Cloud’s AI technology and Augmedix’s ambient medical documentation app. Approximately 75 emergency room physicians at four HCA hospitals have participated in the program, using the Augmedix app on their phones to create medical notes from their conversations during patient visits. The physicians review and finalize the notes before transferring them to the patient’s EHR.

When the latest collaboration was announced in August, HCA said various teams from the health system, Google Cloud, and Augmedix are working with the physicians in the pilot program to refine the documentation solution, which HCA plans to expand to more hospitals this year. 

One of Augmedix’s main rivals, Microsoft-owned Nuance Communications, announced last week that its AI-backed clinical documentation tool, Dragon Ambient eXperience (DAX) Copilot (previously known as DAX Express), is now generally available to health care and life sciences customers. According to Nuance, DAX Copilot automatically creates draft summaries of clinicians’ conversations with patients during exams or telehealth visits “in seconds.” The clinician can then review the summary and enter it in the patient’s EHR. 

Amazon’s Investment in Anthropic
To compete with Microsoft and Google, Amazon said last week it is forming a strategic collaboration with Anthropic, an AI startup, to advance generative AI. Amazon said it would invest up to $4 billion in Anthropic and will have a minority ownership stake in the company. 

Anthropic’s AI assistant, Claude, competes with ChatGPT. The company’s CEO, Dario Amodei, and its president, Daniela Amodei, both worked at OpenAI.

While the Amazon-Anthropic partnership is not specific to health care, Dan Sheeran, Amazon Web Services’ general manager of health care and life science, said in a LinkedIn post the collaboration “is important for health care and life sciences organizations globally.”

“We are already seeing many AWS customers employ Anthropic’s Claude generative AI models via Amazon Bedrock to transform drug development and health care,” he wrote.  

Erik Pupo, director of commercial health IT advisory at Guidehouse, a health care consulting firm, said the collaboration is an “overall good move for the tech giant’s health care ambitions,” FierceHealthcare reported. 

“It introduces more competition and more options for health care teams looking to innovate using different approaches or to get more tactical with their AI strategy,” he added.

Pupo noted that Anthropic’s reputation for responsible AI policies “adds cachet to Amazon’s efforts in health care. Responsible usage of AI will further position the AWS brand as a secure option for storage and analysis of patient data.”

What else you need to know
Elevance Health’s $2.6 billion acquisition of Blue Cross Blue Shield of Louisiana (BCBSLA) is on hold. The organizations said they are withdrawing their merger, which they announced in January and expected to complete by year-end, after Louisiana’s attorney general and state lawmakers sought a delay in the approval process. State officials, including the insurance commissioner, want clarification about how the deal would be structured, since BCBSLA would relinquish its status as a not-for-profit organization to become a for-profit subsidiary of Elevance. The main concerns appear to center on how the proceeds of the acquisition would be distributed, whether the deal would violate antitrust regulations, and if plan premiums and provider networks would be affected. For the merger to occur, the insurance commissioner and two-thirds of BCBSLA’s policyholders would have to give their approval. Elevance and BCBSLA said they “do not believe it is the right time to hold public hearings and a policyholder vote,” according to nola.com, but they “remain committed” to refiling the merger documents at an unspecified date.   

The private-equity owners of Virgin Pulse and HealthComp plan to merge the two companies in a deal valued at $3 billion, creating what Matt Holt described as “the first national value-based care platform company focused on employee health and outcomes.” Holt is the president of private equity at New Mountain Capital, the PE firm that backs HealthComp, a benefits administrator based in Fresno, Calif. Virgin Pulse, a digital health and navigation company based in Providence, R.I., is backed by Marlin Equity Partners. New Mountain will have majority ownership in the combined company, and Marlin will hold a minority stake, as will Blackstone and Morgan Health. The new entity will serve more than 20 million members and address costs for more than 1,000 self-insured employers, the announcement stated. If regulatory approval is obtained and other closing conditions are met, the merger is expected to close in the fourth quarter. Virgin Pulse CEO Chris Michalak will serve as the combined company’s CEO.

Transcarent launched “the first national independent provider ecosystem” with 10 leading health systems as founding participants: Advocate Health, Atrium Health, Baylor Scott & White Health, Corewell Health, Hackensack Meridian Health, Intermountain Health, Mass General Brigham, Memorial Hermann Health System, Mount Sinai Health System, and Virginia Mason Franciscan Health. The model is designed to offer Transcarent’s employer clients and their members a predictable, lower cost of care by directly contracting for rates up front with the network’s health systems. Transcarent, launched by Livongo founder Glen Tullman in 2021 and based in San Francisco, said its direct-to-employer platform regularly pays providers on the same day services are delivered and includes value-based incentives. The company’s platform lets patients make appointments online with in-network providers, schedule home visits, and request delivery of their prescription drugs. 

Miami-based Cano Health sold “substantially all” of its primary care centers in Texas and Nevada to Humana’s CenterWell Senior Primary Care subsidiary for approximately $66.7 million, which includes about $35.4 million in cash and the release of certain liabilities, the company said in a press release. In August, the company revealed that it had “substantial doubt” about its ability to continue operating for another year and said it was seeking a buyer. For now, CEO Mark Kent said selling the centers would help Cano Health refine its footprint and focus on improving its operational and medical cost performance in the Florida market. 

Boehringer Ingelheim and Eli Lilly’s Jardiance (empagliflozin) gained FDA approval as a treatment for chronic kidney disease (CKD) in adults. Specifically, the SGLT2 inhibitor is approved to reduce the risk of sustained decline in estimated glomerular filtration rate, end-stage kidney disease, cardiovascular death, and hospitalization in adults with CKD at risk of progression. Jardiance was first approved in 2014 as an adjunct to diet and exercise to improve glucose control in adults with type 2 diabetes. Subsequent approvals include reducing cardiovascular death in adults with type 2 diabetes and cardiovascular disease; reducing the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure; and a pediatric indication in type 2 diabetes. With the exception of the pediatric indication, AstraZeneca’s Farxiga (dapagliflozin) is FDA-approved for similar uses.

Rite Aid has proposed closing nearly a fourth of its 2,100-plus locations, The Wall Street Journal reported, citing people familiar with the situation. Earlier in September, the Journal reported that the drugstore chain was preparing to file for Chapter 11 bankruptcy. Rite Aid’s debt exceeds $3.3 billion, and the company is facing multiple lawsuits alleging it illegally filled hundreds of thousands of painkiller prescriptions. Rite Aid has denied the allegations, and while it has not confirmed the bankruptcy reports, the company has recently been closing stores abruptly.  

Sacramento, Calif.-based Sutter Health will integrate Sansum Clinic, an outpatient care provider based in Santa Barbara, into its network over the next few years. The non-profit organizations are following through on a non-binding letter of intent they signed in May; their formal agreement takes effect Oct. 2, according to a press release. Financial details were not disclosed, but Sutter Health said it plans to make significant investments in Sansum’s facilities, services, technology, and equipment. A goal of the integration is to expand access to primary and specialty care in the state’s central coast area. 

What we’re reading 
The Cost Shift, The Health Care Ecosystem, And Commercial Prices. Health Affairs, 9.25.23
Government And Commercial Insurer Payment Rates To Hospitals: A Commentary On Priselac. Health Affairs, 9.25.23 (Priselac is the author of the previous article. Both are must-read policy discussions about cost-shifting and the role of integrated delivery networks in cost containment and care delivery.)
Three Key Ways To Strengthen Proposed Pharmacy Benefit Manager Regulations. Health Affairs, 9.26.23

What else we’re reading 
Enlightenment Now: The Case for Reason, Science, Humanism, and Progress by Steven Pinker. I have a few favorite contemporary nonfiction writers, which if you’ve been paying attention to this bonus section you know includes Steven Johnson, Michael Lewis, Jon Krakauer, and Carl Sagan. Tom Wolfe is another (The Right Stuff, Hooking Up), although he made his money on period novels like Bonfire of the Vanities, A Man in Full, and I Am Charlotte Simmons.

But Harvard psychologist Steven Pinker stands out for his prolific writing on language, reason, and rationality in a crowded field that tends to be focused on arguments for evolution (Daniel Dennett, Stephen J. Gould, and Richard Dawkins) or against religion (Christopher Hitchens, Sam Harris, and Dawkins). Pinker is different, adjacently addressing those issues but packaging his ideas for a wider audience.

This is my third Pinker book, and after about a third of the way in, it just might rise to the top. I’m already adding a fourth that I recently discovered on Amazon, which I hope will help contribute to my lifetime project of becoming a better writer.
– JM



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