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Becker’s Healthcare Podcast
Designing AI with Nurses to Reduce Burnout and Improve Care Delivery
00:19:00
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- [00:00]
A
Welcome back to the Beckers Healthcare Podcast. I'm Molly Gamble at Beckers, and we're recording this episode during National Nurses Week, a week dedicated to recognizing the invaluable contributions nurses make in healthcare and in our lives, while also acknowledging the very real challenges they face every day. In light of that, we're having a real conversation today about what it looks like when nurses are the ones helping design AI and what it takes for that technology to be trusted at the bedside. I'm joined by two people leading that work. Jennifer Gam Rushman is Assistant Vice President of Digital Health at Cincinnati Children's Hospital Medical center. And Amy McCarthy is chief nursing officer at Hippocratic AI. Jen. Amy, welcome and thank you for being here.
- [00:39]
B
Thank you, Molly. Thank you.
- [00:41]
C
Thanks for having me.
- [00:42]
A
Jen, I'm going to turn to you first. You recently collaborated with Hippocratic AI on their new nurse facing application, and we're going to get to that. But first, I wanted to look a little bit further upstream from your seat at Cincinnati Children's. Why is it so important to bring innovation into nursing right now? What are you seeing day to day, and how do you see AI?
- [01:06]
C
Yeah, Molly, I think that's such an important question because, you know, one of the things that we're seeing, and I know that people are seeing across healthcare, I mean, even before the pandemic, there was lots of concern about the staffing and nurse availability. And since that time, you know, lots of folks have retired from the profession. They've given it their all. And so we see both, you know, sometimes a challenge with nursing staffing, as well as a lot of young and new nurses in the field. And so when we think about innovating with them, being able to provide them some tools so that they can operate at the top of their licensure, but also really thinking about how do they do what they have been passionate about and what they desire to do at the bedside, provide that personalized, very humanistic part of the care. And then how can we leverage some of these tools like AI to reduce that burden for them and enable them to really perform at that highest level, knowing that there's a finite number of nurses that we're going to be able to have at every patient's bedside? And we want to make sure we give them the tools to do that job to the best of their ability?
- [02:17]
A
Amy, this is really the perfect handoff. We just heard from Jen about some of the effects of the pandemic that are still lingering in hospitals and health systems among nursing teams. Amy, you And I, we met at Becker's annual meeting just a few weeks ago. And that's where this Nurse Copilot from Hippocratic AI first came onto our radar a little bit. Can you take us back to the beginning? Why did Hippocratic launch this product and then how did you go about developing it?
- [02:43]
B
Yeah, absolutely. It's a great question. So you know, when we were thinking about our AI agents, traditionally they have met patients where they are outside of the hospital space. But it was very important to us as we were designing to think about how can AI agents be a part of the entire care continuum. I have been a nurse for over 14 years. I came directly from the inpatient space and so that's an area that I've really passionate about. I've seen firsthand a lot of the administrative tasks and just a cognitive overload that nurses are facing on a day to day basis. So it really was very much a passion project for me to truly sit down and think about how can AI agents be used by nurses? How can we start to use this to redesign their workflow? And that's where Nurse Copilot really came in to be. We wanted it to be a co pilot, an augmentation tool to allow the nurse, as Jen mentioned, to really be able to be present, to be focused on the patient in front of them and to not get caught up in the day to day of just administrative tasks. And so it was very important to me too as someone who's worked in the clinical space, who has had technology handed to her that really didn't make sense in workflows a lot of times to, to sit down with nurses, to sit down with clinicians from the very beginning and to say, so here's the product that we're thinking about. Tell me, does this work? Does it not? How do we co design this together? And you know, the relationship with Cincinnati Children's and several of our co development partners has been just a fantastic examp. Example of this is sitting down, having my team of engineers and researchers sit down with the nursing team, with the clinicians at Cincinnati Children's and say, you know, here's, here's how the workflow is today, here's how we can use AI agents in the day to day to really improve the workflow, to give nurses more of a chance to be present and think about how this can help them with tasks around admissions, discharge preparation, patient education, even family education. And it's been really neat to see the results of that and to see how proud and excited the nursing team is of the work that they've done and they truly become champions of this.
- [04:50]
A
Amy, you just touched on what can so often happen where the technology, the people developing the technology underestimate nurses workflows and think something that's going to be easy to get into the mix is actually to them one more thing to either click or document or another burden to account for. It sounds like Hippocratic AI took the exact opposite approach. Jen, I'm going to turn back to you here. Cincinnati Children's is a special place. You obviously have pediatric and children patients and then also, like Amy just mentioned, the families. Let's talk a little bit about the safety and empathy values of technology, how Nurse Copilot was built. If you can help us appreciate this, Jen, from the clinical side, these two things in nursing, empathy and safety are paramount, especially in pediatrics. What does it actually take for a nurse to trust AI enough when it comes to safety and empathy to really begin to integrate into their care in front of a patient?
- [05:49]
C
Yeah, Molly, you're absolutely right. Right. You know, safety is paramount. That's sort of always first in our mind. And it was, it's been really a great journey with our frontline nursing in the co development of this. I feel like it was really a turning point moment when they could see start to hear the AI agent and then what they were able to do is kind of record their own conversations about how would we have this conversation about sort of hospital basic education, et cetera, and then hear that come to life in a way that they felt like it was not only very safe, we could make changes. Hippocratic AI and others wanted their feedback, wanted them to say, I don't like how this is being said or I don't like how this is being done. But also that it felt very humanistic. We had one patient during our first week of Go Live, the parent had it on speakerphone and at the end of the call the patient was like, I love you. And you know, the AI kind of said, well, I'm not, I'm an AI, I'm not a person. But it was, it was a very humanistic experience. I think really for our nurses. They had to hear that and they had to be able to hear how their feedback could be incorporated, you know, almost immediately. And that really builds that trust. And without them trusting the tool, they're not going to talk about it with patients and families in a way that our patients and families trust the tool. And so that mutual trust is really important because then when the nurses are having Those conversations, they're doing that in a way that the family says, okay, I get it. She trusts this tool or he trusts this tool. So I'm going to take that call, I'm going to engage. And so I think it's been really important and paramount to the design.
- [07:25]
A
Love that detail of signing off with I love you. And the agent correcting or reminding what it actually is. But Jen, I mean, what you just described, that is something that health systems nurses and digital leaders just probably don't get asked enough to weigh in on when it comes to feedback. What changes would you like to see made more broadly? What was it like to be on the receiving end of those invitations to weigh in? You're not just being treated like a customer end user, but you're actually sitting at the table with your nursing leaders and nurses while the product is being designed.
- [08:01]
C
Yeah, I mean, I think that's really been part of what's been game changing about this for us. Not only sitting at the table, we had these sessions with frontline nurses where they were talking about real problems. I mean, one of the examples and one of the reasons we have a call today for just a check in was that they were talking about families where English isn't their first language and the challenge of always having an interpreter for questions like where can mom and dad get a meal? And those types of things. And so the nurses were able to kind of bring to life what are the real challenges that I have that I worry about, that keep me up at night with my patients and families. And then the being able to see a tool designed to kind of meet those needs was, I think, really important for them and for them to feel like again, it wasn't something that was being done to them, but they were being involved in the design of it and being able to make changes to it. It wasn't just lip service to the design of it. It was really, what are we going to do? What are we going to talk about how all of that is going to happen? Was was really influenced by the nurses. It also really helps in adoption. Right. As a digital health professional, that's always the barrier. Right. We can build it, but will they come? And so, you know, I really am hopeful as we continue to roll this out, we're seeing positive trends with adoption from those nurses because they feel like it's theirs. They developed it.
- [09:27]
A
Amy, we're talking about the design of nurse copilot and the stakeholders part in that, as Jen just helped us better understand. Let's go a little bit more under the hood, if we can, for a minute, we understand why Nurse Copilot exists, what it's like for nurses to use it. Can you, Amy, talk more about the engine behind it? How does Hippocratic AI ensure safety in its technology? What are the systems and the standards behind a product like this?
- [09:53]
B
Yeah, absolutely. It's a great question. We recently released our latest model, Polaris 5.0, and it's a continuation of our Constellation model and our commitment to safety. We knew as a company that if we were going to have AI agents that were going, going to be patient facing that they needed to be held to the utmost standard. You know, just like myself as a nurse, right. I have a very high commitment to safety. My license is dependent on that. And so, you know, we do a very rigorous amount of testing when it comes to these AI agents. And the continuation of our benchmarks and our and our new model are really showcasing that. But to kind of walk you through our processes, every AI agent, when we create that, we do dual testing. We have our partners, just like here with Nurse Copilot, Cincinnati Children's and the nurses were a very big part of testing the AI agent. We also do a huge amount of testing on our end. I have a team of nurses who work for Hippocratic who do anywhere from 200 to 500 test calls of the agent before it goes live. I have a team of nurses who even after the agent is having patient facing conversations, they are reviewing the first 1,000 calls, looking for things like clinical and technical errors, and those things are reviewed every day. And even after those first 1,000 calls, we continue to monitor all of our use cases across the board because we know that there's no room for error, there's no room for regression of this model. And so we constantly, as a clinical team have to keep our eye on these conversations, ensuring that they are having safely, that they are, are achieving the goals that our partners are looking for and that we're continuing to promote this culture of excellence. I mean, the model itself has been tested by over 7,500 nurses across the country who are doing continuous calls. And you might ask, you know, why? Why nurses? Why are nurses being asked to do this? Well, I will tell you as a nurse myself, we know so many of the edge cases. And so I often joke with my nursing colleagues, try to try to break the system, try to throw all of those edge cases out there to make sure that at the end of the day, no matter what a patient says or throws at the agent, that we are prepared to handle that conversation in a safe and compassionate manner. And you see the results of that today. In our model, we have had no serious safety events. We continue to have a 99.9 just safety rating across the board. And so it's been a really amazing opportunity to collaborate with nurses at Cincinnati Children's, but also across the country to ensure that this model is safe for patient care.
- [12:36]
A
I love the leadership and the rigor and the commitment to safety behind the challenge of 7,500 nurses to break the model. Amy, I think that says a lot about how you approach this in development. In the spirit of National Nurses Week, you both work with nurses in different lanes, if you will. You're close to this work and I'm so appreciative of the chance to get closer to it through this conversation with you. So let's close out with a forward looking question from both of you as we sit here. With the technology available to us today, if we were to look out the next five, 10 years even, what do you see the future of nursing looking like? What should our listeners be paying attention to when it comes to AI innovation? Jen, I'll turn to you first here.
- [13:19]
C
Sure. It's funny, I was just in a meeting this morning where our CEO said if somebody tries to tell us what it's going to look like in five years, they're probably making it up. So I will just make it up. But for me, I think when we think about health care and the future of nursing, especially with AI, it's going to be getting past the trust hurdle. Right. For patients and families. We had one of our families was kind of peering in as we were filming some introductory videos and things and what are you guys doing in there? And I don't know if I want to talk to AI. And then when we explained it to him, he's down the hall five minutes later telling the nurses like, oh, they're trying to help you out. They're making it easier for me to ask questions and not bother you all the time. And so I really think when we think about that nursing profession that is a finite resource and it's so invaluable to our patients and families, but we have to be able to remove some of the tasks that are constantly layered on to our nurses and allow not only for them to have more time and space to do the higher level nursing skill work, but also I think it's a better patient and family experience at times where we think about I can serve up information. Maybe it's educational content, maybe it's reminders. Maybe it's answering a question that they've already answered for me three times, but on my schedule and my timeline. And so I think that the future of nursing is gonna look very different with AI, but we're gonna have to continue to involve the frontline team and our patients and families in that design where that trust factor is really just gonna impact adoption. But I think in lots of ways it's gonna enable us to take better care of our patients and our families and allow our nurses to leave at the end of their shift. I know Amy says this sometimes. Always worried about what I feeling like I did it and I have support if my family has additional questions and concerns after I'm gone. Right. And so I think that's how we're really going to see AI making an impact for nurses. We need to keep the human in the loop. They need to bring that expertise. But we can help to make sure they don't forget things. They don't, you know, we can reinforce information. I think all of that's going to be ways that we're leveraging AI in the nursing space.
- [15:31]
A
Thank you, John. And I don't disagree with a five year remarks. So, Amy, same question to you. Only this time, feel free to edit the time frame to whatever you're comfortable speaking to. We're talking about the future of nursing and how you see AI innovation, informing that, changing that and influencing it.
- [15:49]
B
Yeah, it's, you know, I think it's an incredible time in nursing. It's a hard time nursing. You know, nurses will often say, you know, they, they don't necessarily enjoy change, but when I'm speaking to nurses across the country, you know, I'm very quick to say AI is going to move faster than anything we've ever seen before. And that's an important thing to know. How do we lean into this conversation? How do we make sure that we're at the table, you know, as we're kind of redesigning what nursing and healthcare looks like. And that's what I'm most excited about to see. I do think to Jen's point, it's hard to think about what this looks like in five to 10 years, but what we do know will be constant is that AI is going to be of a part, part of our workflows in the healthcare space and even more so in the inpatient space, which traditionally has been kind of set aside. There hasn't necessarily been a lot of technological advancements in the inpatient space because it is hard to solve for. But It's a very necessary problem to solve for because I will tell you, we are seeing nurses leave the profession in droves due to burnout, due to moral injury. And so how do we start to create an environment that nurses want to be a part of? I like to say, you know, how do we bring joy back to the profession? How do we create an environment where they can thrive in? And so, you know, with, with products like ours and even just exploring the entire AI space, I think we're in this, the midst of a kind of a renaissance here of figuring out what the smart room of the future will look like. You know, I see the nurse truly as the leader in a lot of just the day to day care. They're typically kind of the air traffic controller, letting everyone know what's going on with the patient, what resources are needed. My hope is, is that, you know, over the next couple years, we equip nurses with the tools needed to do this job more effectively so that they don't leave their 12 hour shifts thinking, man, I did not get to everything I needed to get to today. I just, I didn't feel like I helped my patients enough. That is, you know, that's, that's. As someone who's felt that experience, it's, it's very demoralizing. And so I hope that, that we can use this technology and really co design alongside our bedside nurses to say how do we use this in a way that is just very impactful, very intentional, makes sense in workflow. I think that's something that's so important. It makes sense in the workflow, it makes sense in what the nurse is doing and truly designed for a space that one is going to deliver better patient care, but also allow nurses to truly feel like they're able to sit with their patients, that they're able to have this experience, build that rapport and truly be able to deliver the patient experience we also all want to at
- [18:20]
A
the end of the day, so. Well said. Jen, Amy, I just want to thank you both. This was exactly the conversation I had hoped for during Nurses Week. Not just celebrating nurses, but listening to them, understanding them, and really building for what they need. To every nurse listening, thank you. We see you this week and every other week, so thank you very much and happy National Nurses Week to you. To our listeners. To learn more about Cincinnati Children's Hippocratic AI or Nurse Copilot, please check out the show notes and as always, you can tune into more podcasts from Becker's by visiting our podcast page@beckershospitalreview.com thanks for listening.