Becker's ASC Review

36 HEALTHCARE NEWS 36 Health systems ride the outpatient wave By Laura Dyrda H ealth systems are actively shiing care outpatient in an effort to transform the traditional care delivery system and focus inpatient resources on high acuity procedures. In June, Sg2, a Vizient company, issued a forecast projecting hospital capacity will change over the next decade, driven by higher patient acuity, staffing shortages and the push to outpatient care delivery. Outpatient surgical volumes are expected to grow 18 percent over the next decade to 109.5 million cases, according to the report, with total joint replacements and spinal fusions leading the way. "e shi to the outpatient setting is only intensifying, and at Ochsner, outpatient care continues to be a focus of our strategy," Pete November, CEO of Ochsner Health in New Orleans, told Becker's. "First off, it's what patients want. People want to go home aer a treatment or a procedure to heal with their loved ones; it's more convenient, more flexible and less costly." Ochsner invested in a new outpatient medical complex earlier this year offering primary and wellness care, lab services, outpatient surgery and more. e system also partnered with Novant Health to scale its 65-plus clinic model and expand outpatient care for the senior population. e customized approach provides medical and social support in addition to wellness resources for the aging population. "Shiing more care to the outpatient setting is also the right thing to do to truly make a difference in improving the health of our communities across the Gulf South," said Mr. November. "As we accelerate value- based care, outpatient care is an important part of how we partner with people on their health to keep them well, rather than treating them aer they're sick or injured." David Lubarsky, MD, CEO and vice chancellor of human health sciences at UC Davis Health in Sacramento, is also re-imagining the inpatient hospital's role within the larger system. "We're adapting our hospital to care primarily for higher acuity patients, as we expect low acuity inpatient care will virtually disappear from hospitals, especially academic medical centers, over the next decade," Dr. Lubarsky told Becker's. "For example, inpatient care like orthopedics is moving to a purely outpatient practice, along with other previously inpatient treatments." Ronda Lehman, president of Mercy Health Lima in Ohio, said the system's strategy has evolved in the last three years, sparked by the desire to stay out of the hospital during the COVID-19 pandemic. "It is imperative as we look towards the future of healthcare, that we consider the 'entire' person, not just the episodic hospital care we delivered in the past," she said. "From lifestyle choices to the communities they live, play and work in – we must view healthcare The 'huge gap between hype and reality' for healthcare AI By Giles Bruce W hile generative artificial intelligence will "completely" reshape primary care, there's still a "huge gap between hype and reality" for healthcare AI, a Mount Sinai Health System leader told Becker's. For instance, most primary care visits will one day be transcribed by AI, which will know who's talking and put it into context via the patient's EHR before automatically creating a summary, said Thomas Fuchs, chair of AI and human health at the New York City-based health system. "All conversations will be AI-supported in the future. Primary care will change completely," he said. "But I think that's clear to see for everyone already." Mount Sinai is piloting generative AI for chatting with patients, triaging messaging for physicians, and creating safe chat environments for providers, he said. The health system uses a HIPAA-compliant GPT model from Microsoft. It is also employing large language models to extract patient phenotypes from deidentified EHR data for research in areas such as genomics and pathology, as well as teaching medical students about their optimal usage. But while healthcare AI has "enormous potential," there is also a significant amount of noise to sort through, Dr. Fuchs said. He gave the example of pathology, which has only one AI solution that's been approved by the FDA. "So if you contrast that with the hype and the 12,000 health tech startups and so forth, there's a huge gap between hype and reality," he said. "There's, of course, a long way to go. We're just scratching the surface with what's possible with generative AI and large language models. But we are, as an institution, committed to use it where it makes sense." n "It is imperative as we look towards the future of healthcare, that we consider the 'entire' person, not just the episodic hospital care we delivered in the past." — Ronda Lehman, president of Mercy Health Lima

• Cover