Four questions Hackensack Meridian asks before buying any AI tool

Since 2010, literally thousands of AI companies have flooded the healthcare industry, from enterprise-level behemoths offering revenue cycle management tools and clinical decision support to three-person startups focused on highly specific clinical and operational workflow assistance.

CIO inboxes are bursting with non-stop requests for just five minutes of their time, which, if all of them were granted, would end up being a full-time job on its own. It’s never been more important to develop clear criteria for which partnerships to pursue, especially as health systems find themselves under continued pressure to innovate with AI.

For Hackensack Meridian Health, which recently became the first health system to earn Joint Commission’s new Responsible Use of AI in Healthcare Certification, AI acquisition criteria tie back to several key questions about governance, cost, and utility, said Joel Klein, MD, EVP and Chief Digital and Information Officer.

Do we need it? Do we have something that can do it already? Can we implement it responsibly? And will it be a sustainable solution months or years from now?

Sometimes, those questions can be answered by a smaller vendor with a dedicated point solution. Other times, the health system already has enterprise vendors on board that have developed – or are in the process of developing – functionalities that can accomplish the same goal.

The challenge facing health systems today is piecing together a balanced configuration of the two that can create a safe, secure, interoperable, and effective AI ecosystem to meet clinical and operational needs.

With 18 hospitals and more than 500 patient care locations across New Jersey, Hackensack Meridian Health is no stranger to thinking big.

“We have all the big enterprise platforms that you might expect from a health system of our size,” said Klein. “We have relationships with Epic, Workday, Google, and ServiceNow, among others. These platforms have AI baked into them, so we already have access to a large number of AI tools.”

“We want to use all four corners of these solutions that we’ve already bought and paid for, of course. That’s what makes sense as a first step, and it’s something that a growing number of CIOs are prioritizing right now, particularly as they think about budgeting, privacy and security, and operational complexity.”

But it’s an approach that doesn’t always make the rest of the vendor community happy, he added.

“A lot of AI companies out there are getting overshadowed by the larger vendors who are coming along and integrating all of these individual solutions into their platforms,” he said. “These smaller companies coming to us with the message that their products are better – and yes, sometimes their solutions may be incrementally better in certain dimensions.”

“But if we adopted every single point solution using just that logic, we’d end up with this jumbled garage sale of stuff that’s all duct taped together. The amount of overhead would be ridiculous; they would all be doing updates and upgrades at different times. When one company goes out of business, or they get bought and the price quadruples…where would that leave us? It’s not that we don’t love working with small, ambitious firms. It’s that it’s got to be a predictable and workable somehow.”

On the other hand, he continued, only relying on what enterprise vendors can provide might not be enough to remain on the cutting edge of innovation.

“A lot of the enterprise vendors are lagging behind what’s already available in other segments of the AI market,” he pointed out. “If we wait for a handful of platforms to grind through their internal machinery, finally release something, and then go through a handful of versions of it before it’s really ready for primetime, we might be missing a window of opportunity to iterate and innovate in an area that really needs attention right now.”

In some cases, adopting a solution from a smaller vendor can act as a bridge to equip the health system with a necessary tool while an enterprise platform is still working on its version, Klein noted.

“Bridge vendors help us stay at the forefront of what we want to achieve without committing to a flea market of tools forever,” he explained. “If we can be intentional about it, and have clear expectations around what we’re bringing into the system and why, then we can have the best of both worlds so we can better serve our patients.”

The balance point may be different for every health system, Klein concluded, and is likely to keep shifting as the market evolves. Developing a flexible acquisition strategy that is still rooted in standardized, responsible governance can help health system leaders navigate a changing landscape that is continually coming up with new ideas and new product offerings.

“We believe that avoiding the extremes in either direction is going to be the best strategy,” he said. “We have to have a mix of solutions and relationships that makes sense now and in the future. It’s an approach that works well for us, and one that I see many of my colleagues taking, as well.”

Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.  She can be reached at [email protected].