AI technology empowers accurate tracking of patient episodes across care settings

May 17, 2024 / By Sandeep Wadhwa, MD, MBA, Steve Cantwell

I sat down with Dr. Sandeep Wadhwa, global chief medical officer for Solventum, formerly 3M Health Care, to explore evolving industry trends in healthcare technology.

You recently attended the HIMSS24 Conference and participated in a technology panel. What hot topics emerged at the conference? How is the industry dialogue changing?

Several evolving trends stood out to me. The first was how generative artificial intelligence (AI) has moved from a being discussion topic last year to now seeing widespread demos of capabilities. It’s a striking difference and a big step forward. We’re seeing momentum across the industry. There’s still a healthy tension around how to balance the urgency to get to market quickly with viable use cases for responsible AI—including applications for both administrative simplification and clinical decision making.

As the industry gets more familiar with different AI models, there’s growing consensus about the best ways to apply AI to healthcare issues. At HIMSS24 I heard more discussion on clinical decision support applications for diagnosis and treatment versus administrative uses of AI. But the two concepts come together to enable efficient workflows. I think the top priority needs to be on the reducing administrative burden side — increasing the time to focus on patients and deliver high quality care. There’s great potential to enhance efficiency and support patient-first approaches to administrative tasks.

I also noticed increased focus on the globalization of healthcare technology adoption. I’ve always thought of HIMSS as a global meeting place, but I came away energized by meetings this year with delegations from France, South Korea and Saudi Arabia—to name a few. Global entities are leaning into technology and investing in healthcare digitization. They’re looking closely at what works the United States and exploring what could work even better for them. This is not a lift and shift. It’s more of a learn and advance mentality. They’re exploring sustainable payment models that can bake in quality oversight.

And finally, I saw a focus on solutions to address throughput concerns at hospitals. How can we help our health system partners improve patient access to care and increase patient throughput? As  industry leaders and technology innovators, we can leverage technology, grouping and classification methodologies and consulting expertise to make things run smoother for health systems.

In the HIMSS24 panel you said technology is now helping us access and use longitudinal data to connect events and promote accountability for entire patient episodes of care. Why is this so important?  

It’s crucial from a data and technology perspective to follow a patient through time and space: Looking at “episodes” of care rather than isolated “events” of care. We need to see the “episode” as a meaningful unit for performance, safety, outcomes and efficiency — and advance measurement systems to accurately track episodes of care.

The industry is well poised to shift toward measurement and payment models for episodes of care. We can build on the foundation of well-established methodologies — such as diagnosis related groups (DRGs), which set the boundaries for payment and performance within an inpatient hospitalization — and extend that concept to the pre-event and post event periods.

Take a knee replacement or a hip replacement as an example. Instead of just looking at the day of surgery, we can look at the week before the surgery and the 30 days after. The entire episode of care is a unit for payment and performance. Then if an infection occurs or there’s bleeding at the procedure site, we include this as part of the episode of care, not just as separate payment events. When you isolate stages of treatment as separate payment events, it’s like only looking at one portion of a factory assembly line without being accountable for the ultimate outcome or product.

Importantly, the extension goes both ways. Preparation before a procedure matters to the outcome! Analyzing and managing a patient’s chronic conditions, comorbidities, medications in advance of the surgery becomes a more integrated aspect of holistic care when there’s financial and performance measurement extending before, during and after a procedure. Perioperative care can often determine the outcome just as much as the procedure itself.

Grouping technology helps both payers and providers understand the baseline performance from a longitudinal perspective. What procedures are done in which setting? Which patients are doing better or worse than expected? U.S. News & World Report uses grouping technology to look at 30-day outcomes of selected elective procedures, such as complications that lead to higher than expected emergency room visits.  

The next crucial step is to bring that situational awareness to the point of care, where AI technology can nudge providers during documentation to accurately capture a patient’s whole care journey and improve outcomes as a result.

More complex health care is now taking place outside of hospital settings. This shift brings both new challenges and new opportunities. What do you think we should focus on?

The dramatic shift toward doing more care — and more complex care — in outpatient settings represents a remarkable technological advancement. Not so long ago, the idea of doing an invasive procedure like a hip replacement in an outpatient setting was unheard of.

I think providers and payers should be focusing more on how they track and analyze 30-day outcomes after procedures. With cloud technology, we are beginning to have timely access to more information to accurately identify variations in performance and determine where to make improvements. We can identify warning signs and symptoms that signal the need for proactive outreach. We can help reduce unexpected high acuity emergency room visits and admissions after outpatient procedures.

As an industry we’re at the forefront of performance measurement that will likely turn into incentive systems for outpatient care. We can work together to extend an efficient inpatient safety framework for preventing infections, readmissions and complications to outpatient settings which serve many more people.

Dr. Sandeep Wadhwa is global chief medical officer for Solventum.

Steve Cantwell is a senior marketing communications specialist at Solventum.