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- [00:01]
A
Welcome to advancing health. Artificial intelligence and advances in digital technology give care providers more and better tools for patient care than ever before. In this month's Leadership Dialogue podcast, hosted by Tina Friesdecker, president and CEO of Corewell Health and the 2025 board chair of the American Hospital association, we hear from one expert on harvesting the potential of so many new technologies to deliver better, safer, and more accessible care for patients and communities.
- [00:34]
B
Hello, everyone. Thank you so much for joining us today. I'm Tina Friesdecker, President and CEO for corewell Health, and I'm also the Board Chair for the American Hospital Association. We know that there are many pressures and challenges facing our hospitals and our health systems, but there's also never been a better time to truly transform how we care for people. I believe that AI and other technology innovations play an important role in this transformation, which is why I'm so excited to explore this topic today. With so many tools and technologies out there, it can be difficult to really focus on what delivers that value to the patients, to our communities. That's why I'm so pleased to be joined by Dr. Jackie Gearhart, Chief Medical Officer of Epic, to ensure that we talk about these opportunities for healthcare. In addition to her role at epic, Jackie is also a practicing family medicine clinician, so she can give her firsthand perspective on how she sees technological advances improving care for her patients. So, Jackie, thank you so much for joining us today. We are so appreciative of all you do for epic, but then also what you do to serve people in your community. And it's been a pleasure knowing you throughout the years in various areas. But it's wonderful to be able to talk to you today when you think about the possibilities ahead for us, especially as it relates to technology and all these things that you can learn from. What area do you think we have the greatest potential?
- [01:58]
C
Potential is an interesting term because I think it's kind of two different things. There's the part of it that is the option for transformation, and then there's the part, as you mentioned earlier, that's really practical and being able to be applied now. So. So I do think that AI, the use of agents, the use of bringing that technology into medicine, both the care of medicine and the transformation of new medicine is going to be a game changer. Just like the Internet was transformational, I think this age of AI and AI agents is also transformational. I think in terms of practical, one of the things we struggle with in healthcare is being able to evaluate different tools, understand, are they going to be Useful for our populations. Are they going to be tuned for our specific populations we're caring for? What do we already have? What do we still need to purchase? So I think there's so many pieces out there right now, especially within the AI sphere to help us answer patient messages as clinicians, to help patients be better informed about their care, to be able to use their patient portal epics is called MyChart, to try to better inform them of what's coming up next. So I think while the transformation part is absolutely AI and AI agents in that future, I think just digital health in general, we can't forget that that's something that's already bringing us together with things like telemedic and hear from your phone.
- [03:19]
B
I think that's absolutely correct. That is the digital piece to this and how we're designing it. And we can't design it based on the paper model into a digital model. It's truly transforming. I also think the key element is we need to be clear about the problem we're trying to solve. There's so many shiny objects that are out there that can distract us and we must be laser focused on that solution that we're trying to solve, otherwise we can get very distracted. So when you think about that, we have to evaluate all of these new technologies, this transformation. It's important to evaluate the costs and the benefits of those new innovations. What are some of the criteria that you believe hospitals and health systems should keep in mind when we look at those opportunities and do you see major barriers when we adopt the new technologies?
- [04:07]
C
Yeah, great question. You hit the nail on the head. It's absolutely everyone is inundated with new shiny technologies. And I think the very first question, as you put it, is what is our problem that we're trying to solve? And then I think the second is, do we already have technology that could actually be solving this better than we're using it? Is there something in workflow that we're not optimizing? Is it a people or human factors issue and not even a technology issue? So first evaluating what the problem is and then seeing where within the workflow, literally studying how is it that this could either be more efficient or more effective. And then I would say just like I was talking about before, there's digital health, there's AI. Evaluate if there's already a digital health solution that may be lower cost than the cost and compute of an AI solution and see also if you already have it. One of the things we notice with hospitals is that they have technology that they've already purchased and they may just not be optimizing it or have even turned it on. One of the hardest things we do at EPIC is we create software and we created a very fast clip trying to keep everyone up to date with the best and greatest. But if they don't turn it on or if they don't fully optimize it or help train their users, then it really isn't allowing for that technology to get to the point where it's actually being optimized. So after all of those questions, then when you get to the AI question and in terms of what's cost effective and what's not, oftentimes we see people do one of two things. They'll either kind of do a pilot and then learn if it's the right technology and then try to expand from there. We've actually found that sometimes some of the greatest technology solutions are caught in this death by pilot cycle, where in reality, if you're able to, if you've seen another organization already do it and you're able to apply those results to your organization, you may not need to do a full randomized controlled trial or a full study of it. Just make sure that it really fits in with your clinicians, your workflow and your patient population. Be sure to test it locally and understand that it's going to actually be effective. And then go for it and be a little bit bold about this because this is a technology that's actually really changing and advancing care and we have the opportunity to have that now.
- [06:16]
B
So as a physician, I'm curious to know what you've seen over, you know, your eight years really practicing in that area and maybe even before in your, in your education and training and what you're excited about coming forward and make it easier. And then any advice you have for us as we implement these things and ensure, you know, the whole goal is to make it easier for our physicians and clinicians to provide the care and easier for patients to receive the care. What advice do you have for how we would implement it?
- [06:45]
C
Yeah, great question. So I practiced for about eight years and then started at Epic and I've been at epic for about eight years. I remember this is man, probably in maybe 2015 or so, I had a patient who I was doing a physical exam on, on the exam table in my practice and I was examining her thyroid and I felt a small lump on one side and, and I wanted to finish her exam, but I also wanted to order a ultrasound and think about a fine needle biopsy and also See if she had a prior TSH and all of these different things that were both passive and active. And I felt myself hamstrung till this one point in the exam room thinking, okay, do I turn to the computer? Wouldn't it be great if something could kind of bring this all together, A technology perhaps? And she and I were going back and forth and saying, wouldn't it be nice if I could just say in this case I was using epic? So, hey, epic, order a TSH and follow up in two weeks. And if the TSH is elevated, let's go ahead and do an ultrasound. And then, by the way, you know, record this into my note and also give me some decision support as to, you know, what is going to be covered by her insurance, et cetera. And she was a little bit of a tech nerd. So we geeked out about it for a while. And it really got me thinking as one of the reasons for me wanting to get into tech is that, yes, I can. I love patient care and I can have such a good impact on the people in front of me. But if there's a way to truly transform medicine, to try to make it both easier on clinicians and also more practical for just getting access to care and being able to democratize care, then that's really the secret sauce. We just had our users group meeting UGM a few weeks ago, and I was so thrilled because it was kind of this way that we embodied everything I was hoping for all those years ago. We showed how a patient with their my chart can go in and actually speak and ask questions to be able to create a patient agenda. So instead of a patient coming in to me and me saying, hey, what brings you in? Or what else? And then having my hand on the door and leaving and being like, oh, there's one more thing. I can actually pace the visit by having the patient tell me specifically what it is that they want to accomplish. And then on the clinician side, we have art, which is the AI for clinicians, and that then in real time can go through the patient agenda and choose each topic. So say the first one's hypertension. It can bring up to me a summary of all of the hypertension information that's in the chart, as well as blood pressure cuff information that they may have from home, and even help me with decision support using real world evidence and actually looking at that person themselves, how old they are, what they've tried before, and help me decide what might be the best course of action for this person with all of the tools that I have in my tool belt.
- [09:32]
B
Do you see patients readily engaging in this and do you see the potential for the use of technology and the things that allow us to do things like sharing the agenda, changing patient behavior to more healthier behaviors?
- [09:50]
C
Yes. So I think I discussed some stuff in the exam room and I think that's really important for, for changing behavior and treatment. But really, again, it's those in between spaces that actually have the biggest opportunity for changing behavior, I think. And so I've loved how some of the technology we're using, again going back to just digital health, I was speaking about a how wearables can help affect people's behavior. What's interesting is we have a website called epicresearch.org where we study different questions of Cosmos, which is a real world evidence platform. One of the questions I had asked was in patients that are wearing a prescribed continuous glucose monitor, in those patients pre diabetic, just wearing it to try to improve their health. In those patients, does their A1C change? And it turns out over all of those patients, it didn't have a statistically significant change. That was actually surprising to me because I thought behavior would change enough. But then as I went back, I thought, you know what, I'm asking the wrong question. It's not whether the A1C which is a measure for diabetes is really the question. It's while the rest of their lifestyle, what's their bmi, are they getting heart disease, how's their hypertension? All of the other things that we need to look at to determine if something is actually changing behavior. Because the behavior of change actually might be the thing that we should be measuring. And it brings me to this thought of traditionally in medicine we've thought of things like labs or treatments or medications and it's very much been sort of like a medication focused career. And I really think we have the opportunity now to further expand that into a person focused career and really have it be you tell me what it is that you're coming in for. Maybe it's you just want to make it down the aisle and so I need to help you with your knee pain. Maybe it's not that I need to fit what is on my agenda, but it's actually what's on your agenda.
- [11:47]
B
That's fantastic. That's really good. So I'm going to close today with just asking you about what you're most excited about when it comes to innovation and transformation.
- [11:54]
C
I'll go second. Why don't you tell me what you think you're most excited about, oh, I.
- [11:58]
B
Love it, how you're turning over to me. I'm really excited about the potential that we can create. Yeah, I think that there's so much opportunity for harnessing some of the new technologies and artificial intelligence, but really seeing the impact to patients. I was just in talking to some of our teams the other day and hearing about the amazing progress we've had. When you talk about surgery, when you talk about the research elements, and we're just at the cusp. I mean, you feel like you've made so much progress, but there's so much more that we can do. And that's what gets me excited. And really the impact is back to patient care. I was just rounding and met one of our patients and he had an essential tremor and he couldn't sign his name for 30 years. And so we did a focused ultrasound procedure where we have the laser focused on part of the brain, heated up to 58 degrees Celsius, which is like 130 plus degrees Fahrenheit. And after the procedure, he could draw a straight line, he could sign his name. And he sent us a handwritten note, two page, handwritten note that he wasn't able to do before, detailing his gratitude and how he can now hold a cup of coffee and drink from it. So that is the incredible piece that I see why I'm in healthcare and what I'm so excited about. To see the progress that we can make and the impact we can have on people.
- [13:33]
C
I love that story. That's beautiful. I completely agree. It centers around the patient in addition to specific patient care. I'm thinking also about the broad population health and what can this do to advance medicine. And I think as clinicians, we tend to think about the information that we put into a record or the information we gather, and we see that as part of the healthcare visit. But then it's kind of put into the background and I really think that data isn't the exhaust of healthcare, but instead it needs to be the fuel for personalized medicine. And as we start to learn from these journeys, and AI can learn from these journeys more quickly than humans can, we actually can figure out how to personalize medicine, advance new cures, figure out how to research things more quickly and hopefully get that out to people. One of the things people have is they just, they're curious. They want to know what's going on and how it can be be fixed or helped. And I think as that curiosity grows, we have more and more tools to help inform and democratize data for patients and also inform personalized care.
- [14:41]
B
Our health is an everyday, every minute sort of thing. It's really important that we connect all of that data and we give people the tools that they need so that they can reach their health outcomes and.
- [14:51]
C
Their goals they want to achieve.
- [14:53]
B
Jackie, thank you so much for your time today, for sharing your insights and expertise, for hearing for our communities, and for being so active and a supporter with EPIC and partnering with the American Hospital Association.
- [15:06]
C
Yes, thank you. It's been a joy. Thank you so much.
- [15:08]
B
And thank you to all of our viewers for finding the time to tune in. We will be back next month for another Leadership Dialogue conversation. Have a wonderful day.
- [15:17]
A
Thanks for listening to Advancing Health. Please subscribe and rate us 5 stars on Apple Podcasts, Spotify, or wherever you get your podcasts.