Cadence, an AI-powered and clinician-led distant affected person care expertise and companies firm, not too long ago appointed Dr. Eve Cunningham as its chief medical officer. She has spent the final 20 years deploying transformational well being IT applications at supplier organizations, main giant, multidisciplinary medical teams and integrating AI into clinical care at a few of the largest non-profit well being methods within the nation.
Cunningham most not too long ago served as chief of digital care and digital well being at Windfall well being system.
Well being methods of all shapes and sizes face challenges with entry to major care, scaling power illness administration applications, lowering readmissions and size of keep, and attaining high quality targets for Medicare sufferers. Cadence’s objective is to assist well being methods overcome these challenges.
We spoke with Cunningham not too long ago about her new function, and obtained her ideas on reimagining how clinicians practice care, essentially the most urgent difficulty in healthcare at present and how digital care might help, AI’s function in clinical care evolution – and the modifications wanted to create a extra sustainable and patient-centered healthcare system.
Q. You latterly transitioned from a management function at a significant well being system to the startup life with Cadence. You’ve got been in management roles in a number of giant nonprofit suppliers. What made you make a transfer from a conventional well being system to a distant care supply system within the digital well being area?
A. I’ve spent the previous 22 years of my profession working in a few of the largest nonprofit well being methods within the nation, serving in a wide range of clinical, operational and innovation-focused management roles. All through that point, I had a front-row seat to each the unimaginable strengths and the numerous challenges that well being methods face – significantly as they work to satisfy rising affected person demand, tackle clinician burnout and combine new fashions of care.
Whereas well being methods proceed to do unimaginable work, it has turn out to be more and more clear that the way forward for care supply would require sturdy partnerships between supplier organizations and a portfolio of revolutionary well being tech corporations. The important thing to significant transformation is not nearly adopting new applied sciences – it is about thoughtfully integrating methods that improve affected person care, scale back the burden on clinicians, and enhance operational effectivity in a manner that is sustainable for well being methods.
This is such an thrilling time for the business. We’re seeing widespread adoption of digital well being methods, distant care fashions and team-based approaches which have the potential to make healthcare extra proactive and accessible. The business is reaching an inflection level the place we’re shifting past pilot applications and early-stage adoption to true integration at scale.
That is what makes this second so compelling – there is a chance to assist bridge the hole between revolutionary care fashions and real-world implementation on the well being system degree. That form of transformation is one thing I’ve all the time been captivated with, and it was clear to me that my subsequent step ought to contain working on the intersection of well being methods and expertise.
After I began interested by what sort of function I wished to pursue, I knew I wished to be on the business facet of healthcare expertise and companies, bringing my expertise, relationships and deep understanding of well being system operations to an organization that is making an affect in care supply. The chance to take on this function aligned naturally with my expertise and targets.
I had already been working intently with the crew in a strategic advisory capability for greater than two years, so I had firsthand information of the folks, the mission and the imaginative and prescient for the long run. As I look forward to the approaching years, I see unimaginable potential for development and affect.
I really feel extremely lucky to be a part of such a gifted crew, and I am deeply grateful to my colleagues who’ve helped make this transition seamless, together with those that will proceed to play pivotal roles within the clinical management of the group.
Q. You say that in your new job you need to reimagine how clinicians practice care. What does that transformation appear like?
A. Reimagining how clinicians practice care requires breaking away from the deeply ingrained constructions of conventional healthcare supply and embracing new fashions that increase entry, enhance outcomes, and higher assist each sufferers and clinicians. Traditionally, care supply has been constructed round episodic interactions – sufferers coming right into a clinic or hospital for scheduled visits, with lengthy gaps in between.
Whereas this mannequin has labored for many years, it is more and more misaligned with the realities of at present’s healthcare panorama. The rising burden of power illness, the clinician workforce scarcity and rising operational prices all demand a brand new strategy that makes care extra steady, proactive and scalable.
At its core, care transformation is about shifting past incremental enhancements and as a substitute essentially restructuring how care is delivered. This implies integrating collaborative and team-based care fashions, leveraging digital infrastructure to increase care past the 4 partitions of a hospital or clinic, and discovering methods to interact sufferers extra successfully in managing their well being.
When new fashions of care are examined and confirmed to enhance outcomes, they signify innovation. However true transformation occurs when these improvements scale – after they turn out to be the brand new customary of care throughout well being methods, benefiting hundreds of thousands slightly than hundreds of sufferers.
This shift is extremely difficult. Physicians are skilled in a particular manner, and well being methods have been constructed to assist conventional care fashions. Most hospitals and clinics merely wouldn’t have the infrastructure in place to orchestrate a digital or hybrid workforce at scale. The clinician scarcity solely compounds this problem.
In the present day, we’re already dealing with a extreme scarcity of healthcare suppliers, and the issue will solely worsen because the inhabitants ages. In the meantime, power illness administration stays alarmingly insufficient – solely about half of sufferers with hypertension are adequately dosed, greater than half of diabetics aren’t in good management, and solely a small proportion of coronary heart failure sufferers are correctly dosed on guideline-directed remedy.
With 10,000 folks getting old into Medicare day by day, the hole between affected person wants and obtainable care will proceed to widen until we essentially rethink how we ship care.
A 20-minute workplace go to each few months is merely not an efficient method to handle complicated, ongoing well being circumstances. But, many conventional well being methods battle to restructure their workforce because of monetary constraints, operational complexities and widespread clinician burnout.
This is why it is so vital to discover new fashions that permit clinicians to work on the prime of their license, whereas additionally increasing the care crew to incorporate different professionals who might help handle sufferers extra successfully.
To actually scale ourselves as clinicians, we should rethink who does what in healthcare, leverage expertise to streamline and assist care, and construct the precise organizational constructions to make these modifications sustainable.
Finally, we’ve to maneuver towards a healthcare system the place entry is not dictated by clinic availability however by affected person want. Many healthcare visits at present are pointless or could possibly be dealt with in another way if care fashions had been higher aligned with trendy capabilities.
Whereas reimbursement constructions nonetheless play a task in shaping care supply, we’re at a second the place forward-thinking organizations are proving that it is attainable to revamp care in a manner that advantages each sufferers and suppliers. The problem now is guaranteeing that these improvements aren’t simply small-scale experiments however turn out to be the blueprint for the way forward for care.
Q. What is essentially the most urgent difficulty in healthcare proper now? And what function can digital care and distant affected person monitoring play in serving to sort out the problem?
A. Probably the most urgent difficulty in healthcare at present is that our present infrastructure is unsustainable. The US spends extra per capita on healthcare than another developed nation, but our outcomes lag behind. An excessive amount of of our system is centered on “sick care” slightly than proactive, preventative well being measures that might scale back the burden of power illness.
Well being methods, significantly these in rural and underserved areas, are underneath immense monetary pressure, grappling with rising prices, clinician shortages and an getting old inhabitants that is rising the demand for medical companies. With 10,000 folks getting old into Medicare day by day, the hole between affected person wants and obtainable assets is rising at an alarming fee.
If we proceed down this path with out rethinking how care is delivered, we’ll see much more hospitals closing, significantly in rural communities, and even larger challenges in entry to high quality care.
A main driver of this disaster is the best way we at the moment handle power illness. Situations like coronary heart failure, hypertension and diabetes are among the many most typical and expensive to deal with, but they continue to be poorly managed for a good portion of the inhabitants.
For instance, solely about half of sufferers with hypertension are correctly dosed, and greater than half of diabetics aren’t assembly their glucose targets. The usual strategy – transient, rare workplace visits – is merely not ample for managing complicated, long-term circumstances that require steady monitoring and changes.
Sufferers want extra frequent contact factors, steering on treatment adherence, and assist for behavioral and way of life modifications that may have a big affect on their well being. Likewise, clinicians want higher, extra well timed knowledge to make precision-driven choices about therapy. With out these parts, we’re always taking part in catch-up, treating issues as a substitute of stopping them.
Digital care and distant affected person monitoring have the potential to function a lifeline on this disaster. By leveraging expertise to increase care past the normal workplace go to, we are able to reorchestrate care supply in a manner that meets sufferers the place they’re – whether or not of their houses or communities – slightly than relying solely on in-person interactions.
Proactively managing power illness by way of steady monitoring and digital touchpoints permits well being methods to intervene earlier, stopping the poor outcomes that happen when circumstances like coronary heart failure or hypertension go unchecked. This shift can scale back hospitalizations and decrease prices, and finally enhance affected person high quality of life.
Past power illness administration, digital care additionally addresses one of many largest structural points in healthcare at present: clinician shortages. With fewer suppliers obtainable to satisfy rising affected person demand, we have to discover methods to scale the experience of current clinicians with out overburdening them.
Digital care and team-based approaches assist distribute care extra successfully, guaranteeing that sufferers obtain the precise degree of consideration whereas permitting physicians to focus on essentially the most clinically acceptable care for in-person visits.
By embracing these fashions, we’ve a chance to make healthcare extra sustainable – not only for the well being methods struggling to remain afloat, however for the sufferers and clinicians who rely on them.
Q. AI is typically seen as each a chance and a problem in healthcare. How do you see its function in clinical care evolving?
A. AI presents some of the important alternatives – and challenges – in trendy healthcare. Its potential to boost clinical care, optimize workflows and increase entry is plain, however its integration should be considerate, moral and clinically validated.
As we transfer ahead, AI’s function in healthcare will doubtless evolve in three key areas: augmenting clinical choice making, lowering administrative burdens and enhancing affected person engagement.
First, AI has the potential to dramatically improve clinical choice making by synthesizing huge quantities of affected person knowledge, figuring out tendencies and providing insights that is probably not instantly obvious to clinicians. In specialties like cardiology, oncology and power illness administration, AI-driven predictive analytics may assist determine sufferers in danger for issues earlier than they expertise signs, permitting for earlier intervention.
Nonetheless, whereas AI can assist choice making, it should stay simply that – a assist instrument. Clinicians ought to all the time be the final word choice makers, utilizing AI-generated insights as an assist slightly than an alternative choice to medical judgment. The problem lies in guaranteeing that AI fashions are clear, explainable and free from bias, which requires rigorous validation and steady monitoring.
Second, AI has the potential to considerably scale back the executive burden that contributes to clinician burnout. In the present day, physicians and nurses spend an awesome period of time on documentation, coding and different non-clinical duties.
AI-powered automation, together with ambient expertise for documentation and workflows, clinical summarization software program, and clever charting, might help streamline workflows, releasing up clinicians to focus extra on direct affected person care. The important thing right here is guaranteeing that AI methods really improve effectivity slightly than add one other layer of complexity to an already strained healthcare system.
Considerate implementation, guided by clinician enter, will likely be important to creating AI instruments which can be each efficient and user-friendly.
Lastly, AI can play a vital function in enhancing affected person engagement and well being literacy. Customized well being teaching, chatbots and AI-driven distant monitoring instruments might help sufferers higher perceive their circumstances, adhere to therapy plans and take a extra energetic function of their well being.
Nonetheless, there is a wonderful line between AI as an enabler and AI as a barrier to care. Whereas automation might help scale outreach and engagement, it can’t exchange the human aspect of medication – particularly for sufferers with complicated circumstances who require nuanced, empathetic communication.
As AI continues to evolve in healthcare, the problem will likely be balancing innovation with accountable implementation. AI is not a silver bullet, nor ought to or not it’s used to exchange human clinical experience. As a substitute, its best potential lies in augmenting care supply, permitting clinicians to work extra effectively whereas enhancing affected person outcomes.
The trail ahead requires rigorous oversight, clear moral tips, and a dedication to making sure that AI-driven healthcare stays patient-centered, equitable and clinically sound.
Q. When you concentrate on the way forward for care, what do you envision? What modifications have to occur to create a extra sustainable and patient-centered healthcare system?
A. A sustainable healthcare system should tackle three vital areas: entry, effectivity and high quality. Entry stays a big problem, significantly in rural and underserved communities the place supplier shortages are most extreme. To shut this hole, we have to embrace new fashions of care supply that leverage digital well being instruments, distant monitoring and digital care to increase the attain of clinicians.
By decentralizing care and assembly sufferers the place they’re – of their houses and communities – we are able to scale back pointless hospital visits and present extra well timed, preventative interventions. This shift won’t solely enhance outcomes but additionally alleviate the rising pressure on overburdened emergency departments and major care places of work.
Effectivity is one other key space that requires transformation. The best way healthcare is delivered at present is typically fragmented and inefficient, resulting in extreme administrative burdens on clinicians and pointless prices. By rethinking how care groups are structured and deploying expertise to automate non-clinical duties, we might help clinicians function on the prime of their license and spend extra time focusing on affected person care.
Staff-based approaches that incorporate nurses, superior practice suppliers, pharmacists and well being coaches alongside physicians can create a extra sustainable mannequin for managing power illness, guaranteeing that sufferers obtain extra frequent touchpoints and tailor-made steering with out overburdening docs.
Lastly, high quality should stay on the heart of all healthcare transformation efforts. Shifting to extra proactive, steady care fashions is not nearly scaling companies – it is about enhancing outcomes and making a optimistic clinical affect. In the present day, we all know that many power circumstances aren’t nicely managed underneath our present healthcare system.
We have to make it simpler for sufferers to remain engaged of their care, whether or not meaning offering extra real-time knowledge, leveraging behavioral science to encourage adherence, or redesigning the affected person expertise to be extra intuitive and much less fragmented. Probably the most profitable fashions will likely be people who seamlessly combine digital instruments with human-centered care, guaranteeing that expertise enhances – not replaces – the clinician-patient relationship.
To create a extra sustainable, patient-centered healthcare system, we should be prepared to interrupt away from the established order. This implies embracing new applied sciences thoughtfully, restructuring care groups strategically, and guaranteeing that monetary incentives align with higher affected person outcomes slightly than merely driving extra volume-based care.
The trail ahead requires collaboration between well being methods, expertise corporations and policymakers, all working towards a standard objective: a healthcare system that delivers higher-quality care, at a decrease value, whereas enhancing each affected person and clinician experiences.
If we are able to obtain this, the way forward for healthcare will likely be one which is not solely extra sustainable but additionally extra equitable, extra accessible, and, finally, more practical in conserving folks wholesome.
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