For nurses at Houston-based University of Texas MD Anderson Cancer Center, tech adoption hinges on one question: Does it improve patient care?
“Nurses have long memories,” said Lavonia Thomas, DNP, RN, chief nursing informatics and innovation officer of MD Anderson. If a technology fails — especially as a result of them not being involved in the implementation process — they might be less likely to adopt it in the future.
The $7.3 billion organization is keeping this in mind as it explores how AI and other emerging technologies can give nurses and other clinicians more time at the bedside. In this Becker’s Q&A, Dr. Thomas and MD Anderson Chief Innovation Officer Dan Shoenthal explain why building trust and understanding workflows are critical to determining which tech succeeds.
Question: When it comes to AI, where are you seeing the most meaningful clinical or operational impact today, and where is it still more promise than reality?
Dan Shoenthal: Generally, the vast majority of solutions are promise, not reality. On the research side, in the therapeutic development space, we’ve seen promise from AI.
In terms of commercial solutions, there’s more hope than actual real impact being seen. Where we’ve seen impact is probably in simpler tasks. If you think about tools that have gotten a lot of press, it’s things like ambient solutions. What they do today is very simple — improving documentation, very basic tasks.
Other areas where we’ve seen promise are spaces like supply chain. There’s a lot of waste in healthcare, and there’s a lot of promise for cost savings there.
Dr. Lavonia Thomas: One of the things that comes to mind is you’ve got to build the foundation first. A lot of people want to talk about the AI solution — that’s the roof. There’s a lot in the middle.
With nursing, a lot of it is looking at what is out there, ideating, and matching what our problems are. There’s no point bringing AI in if it’s not going to solve a problem or help patient care. Nurses are the guardians and the patient advocates, and that’s a crucial question nurses are always going to ask.
Q: Innovation often fails at the point of adoption. What have you learned about integrating new technologies into clinical workflows?
LT: The success is going to depend on the workflow design, the nurse acceptance, and incremental trust building, more so than the sophistication of the technology itself.
I have not yet deployed AI in nursing. However, I have successfully led the integration and scaling of virtual nursing across MD Anderson, and that required many of the same principles.
We intentionally started by leveraging technology we already had. We didn’t deploy full in-room camera suites. We used iPads and launched secure video visits for the virtual nurse.
We selected very basic but very important workflows around admission and discharge. Those carry a significant administrative burden and pull bedside nurses away from other direct care activities.
Once they saw it in action, the list of workflows just grew exponentially. I fear that had we made all that capital asset investment before testing user acceptance, it would not have been as well accepted.
DS: At a broader institutional level, you have to have good partners and people who are deep domain experts.
Me trying to understand how a front-line nurse works is not going to meet the need. Some of the subtle things Lavonia pointed out, like user psychology, how people think about experimentation — if you don’t frame that properly, you might not be able to work with that group forever.
How I work with nursing is different from how I work with finance or supply chain. Different groups have different expectations and different day-to-day stresses.
Q: Ambient AI has been more challenging to apply in nursing workflows. How are you approaching that?
LT: We’re talking to nurses about the struggles they have with documentation, getting them to ideate around what this technology could do, and letting them look at the technology.
Sometimes you introduce something and it doesn’t work, but that’s as much knowledge as if it does work. It’s not the technology — it’s the work design and the user adoption that’s either going to say this is successful or not.
DS: We had experimented with ambient technology on the physician side prepandemic. We paused the effort, but we learned a lot. The technology wasn’t ready, and the practice patterns weren’t ready. Fast forward three years, and now we’re deploying those technologies broadly on the provider side and beginning experimentation within nursing.
Q: How do you think about ROI, especially given the cost of AI investments?
DS: One element of the foundation, especially with AI, is data. We made a fairly significant investment in maturing our data infrastructure and our data strategy.
With ambient tools, we haven’t necessarily seen a hard-dollar return, but we’ve seen very positive impact in terms of cognitive load for providers and enhanced patient experience. At some level, it’s hard to measure that financially.
Q: Looking five to 10 years ahead, how do you expect emerging technologies to change cancer care delivery?
DS: What we’ve been focused on is setting up a culture and environment that creates a flywheel for innovation. One bet we’re placing is that for the first time in a long time, we’re going to untether providers from machines. Ambient solutions are a first step in allowing providers and patients to engage at a much deeper level.
LT: Our North Star is whatever we do, we do it to give the front-line nurse more hands-on time with the patient.
Q: How else are you engaging nurses in shaping the future of innovation?
LT: We’re hosting innovation days where nurses can see what 2035 could look like and talk to us about how they feel about that.
We’ve established innovation units and an innovations work group largely comprised of front-line nurses. We’re launching a work-sampling study to delineate pain points.
The introduction of technology for technology’s sake is only going to increase the workload of the nurse, and that is not where we want to go.
The post Why nurses are AI gatekeepers at MD Anderson appeared first on Becker's Hospital Review | Healthcare News & Analysis.
Source: Read Original Article
