What happened at HLTH 2024

A major focus on AI

AI was discussed perhaps more than any other topic during HLTH. The conference, vendors, and speakers seem to have started to reject the high-level platitudes on generative AI that we saw last year. While there were still moments of flash over substance (it's Vegas after all), 2024 ushered in some welcome specificity on the future of generativeAI. For example, in an interview, Stanford Medicine CMO Christopher Sharp said the health system is adopting Microsoft's Nuance nursing AI tool, which Microsoft announced on Oct. 10.

"We basically saw nursing as an imperative out of the gate," Sharp said. "Nursing has a very difference documentation type of workflow. Physicians tend to describe a narrative while nurses tend to have individual discrete data that they need to actually file."

Sharp added that Stanford has around 1,000 users of the AI product from Microsoft, with 94% saying that they've been able to use it with minimal support needed.

Separately, Microsoft's chief science officer Eric Horvitz said the company's imaging-focused AI models, which will allow providers to analyze multiple data types, still need to be developed and refined before they're used.

"These are not, I would say, ready for prime time," Horvitz said. "They are prime tools for the creative audience [at HLTH] and the creative community [at large] to work on."

Microsoft has partnered with Providence to refine the models. Providence has begun integrating imaging, genomic, and pathology data to improve cancer diagnostics.

There was also a focus on utilizing AI to ease the burden of documentation on physicians. For example, Amazon One Medical announced it will provide a series of AI tools to its clinicians, including the clinical ambient documentation technology HealthScribe developed by Amazon Web Services, as well as AI-drafted patient messages and AI-generated summaries of a patient's medical record.

GE HealthCare also unveiled a new AI application called CareIntellect for Oncology. According to GE HealthCare's chief science and technology officer, Taha Kass-Hout, the CareIntellect applications will aggregate multiple forms of patient data from disparate systems into a single view and utilize generative AI to summarize clinical notes. These applications will be built using a common cloud, digital infrastructure.

"Think about the smartphone in your pocket … and how you can use a wide variety of applications with a single login," he said. "That's how CareIntellect works."

In addition, Mike Pontillo, implementation executive at Epic Systems, said the company has developed AI for patient-clinician messaging but plans to expand into billing use cases like automating claim denial appeals.

"It's about trying to figure out what are the use cases that'll free people up to practice at the highest level either for their license or their role," Pontillo said. "We don't necessarily need a nurse to call a patient and remind them about their colonoscopy. That's something that could be automated."

Nvidia also announced multiple AI partnerships in the healthcare industry. Kimberly Powell, VP of healthcare for Nvidia, said the company's computational architecture allows various health technology partners to develop generative AI models across a number of use cases.

Powell announced that Nvidia is working with consulting firm Deloitte to develop digital AI agents for health systems that are virtual representations of a human and can connect directly with patients. Deloitte and Nvidia intend to develop and market the technology to other health systems for different use cases, Powell said.

"We can take this capability of customizing digital agents of all kinds to create new experiences and reduce administrative burden and provide connectivity to all humans with the right digital information," she said. "[We can] provide that to hospitals around the country and many more around the world."

Meanwhile, Google Cloud said it's working with health systems like HCA Healthcare and the Mayo Clinic to develop its Vertex AI Search for Healthcare product, which was made available earlier this month.

"We do it with them, not for them," said Aashima Gupta, Google Cloud's director of global healthcare solutions. "They understand their workflows better. They understand the nuances of use cases [and] where they're spending the most time."

Rural health systems are struggling with technology

Despite the focus on the most advanced versions of technology, HLTH also called out the reality that many health systems aren't in a place to invest in or scale advanced technologies. In one panel, executives said technological innovation is still a challenge in rural areas.

Melissa Cohen, chief innovation and transformation officer at Cayuga Health System, said it's taken longer to build up the necessary infrastructure for technological advancement.

"A lot of rural health systems like us are just now getting Epic," she said. "For us, it's going to take a little bit to catch up to the tech and infrastructure required."

Access to technology isn't the only thing, according to Mike Mosquito, who helps lead emerging technology and innovation at Northeast Georgia Health System.

"It's not only broadband. It's having the resources in the community," Mosquito said. "When I … go into southern Georgia, not only do we have food deserts, but we have health deserts. We had a mayor tell us they play rock, paper, scissors with [the town's] one ambulance. Heart attack, car wreck — who's going to get it?"

Big partnerships announced

A number of partnerships between health systems and various companies were also announced at HLTH.

Amazon One Medical announced it will collaborate with Cleveland Clinic to open a primary care office in 2025, with plans for more locations within the next few years.

"We're starting small with a couple of locations … then we'll see where it takes us," said Tomislav Mihaljevic, CEO and president of Cleveland Clinic. "We're continuously evaluating potential partnerships, and this is the one that just rose to the top of what we think is the right thing for our patients," he added. 

Meanwhile, Blue Shield of California announced it is partnering with Salesforce to create a prior authorization solution utilizing the Salesforce Health Cloud platform. This intends to help stream more than 20 different data systems into one process and make prior authorizations faster.

The platform will be able to search electronic health records for relevant clinical information and compile it into a pre-populated form, which will allow providers to submit requests on the spot, Blue Shield said in an announcement. Testing is expected to begin in early 2025, with a limited rollout later that year.

In addition, Uber Health announced its plans to partner with NationsBenefits to give Medicare Advantage members the chance to use health benefit cards on Uber rides and Uber Eats grocery delivery services.

Discussions about the safety (and limitations) of compounded GLP-1s

One of the biggest challenges with glucagon-like peptide-1 agonist drugs (GLP-1s) is making sure the patients, purchasers, providers, and manufactures get value from these drugs, healthcare executives said during the Wednesday summit devoted to questions about the future of weight management drugs. 

Terry Gilliland, president and CEO of Geisinger, said around 10% of its medical costs are from employees using GLP-1s. He added that many patients stop taking the drugs after less than a year, raising questions about the essential role of comprehensive weight management support and whether the drugs provide any payoff. 

Other experts also raised concerns that compounded GLP-1s could jeopardize patient safety. Kavita Patel, a professor of medicine at Stanford University, said the rising popularity of GLP-1s and their compounded versions suggest a failure in the care delivery system for obesity, nodding to the rise in third parties and vendors looking to fill gaps left by the traditional delivery and payment system. 

In a separate panel, telehealth companies prescribing compounded GLP-1s defended their decisions to do so.

Advisory Board's Rae Woods addressed the immense desire and growing therapeutic scope for these drugs. In a conversation recorded for the Radio Advisory Podcast, Rae invited Rob MacNaughton, CEO of Calibrate, Rita Glaze-Rowe, President at Real Chemistry, and Spencer Nadolsky, a lipid and obesity physician, to address where GLP-1s alone fall short, and how comprehensive obesity care can enable sustainable metabolic outcomes. 

MacNaughton described how third parties like Calibrate provide essential support that goes beyond weight loss — including one-on-one coaching, behavioral health support, and a focus on sleep alongside better physical activity and nutrition. 

While these new partners offer support in addition to GLP-1s, the panelists acknowledged the challenge of fragmentation as different players assert new control over the patient relationship. The ultimate goal is that wrap around support helps patients and purchasers find long-term value from high-cost, high-demand drugs. 

To hear the conversation in full, subscribe to Radio Advisory wherever you get your podcasts and get access to the latest episodes, every Tuesday. 

Biden administration announces funding for research in women's health

First Lady Jill Biden announced $110 million in awards from the Advanced Research Projects Agency for Health for 23 recipients to fund research in women's health.

"It seems like women's bodies are considered miracles when we're in our childbearing years and mysteries as we age," Biden said. "I knew that this had to change."

The funding recipients include:

• Beth Israel Deaconess Medical Center, which will receive $9.1 million to study brain disorders in women
• Vanderbilt University Medical Center, which will receive $3.3 million to develop at-home treatment for preterm labor
• Massachusetts General Hospital, which will receive $3.3 million to help women achieve restorative sleep and reduce neurodegenerative disorder risk
• Tufts University, which will receive $3 million to develop AI tools to measure pain
• University of North Carolina at Chapel Hill, which will receive $3 million to develop personalized treatment for migraines in women

(Hudson/Perna, Modern Healthcare, 10/20; Hudson/Perna, Modern Healthcare, 10/21; Hudson/Perna, Modern Healthcare, 10/22; Hudson/Perna, Modern Healthcare, 10/23; Adams, MedCity News, 10/23)

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