Cardiology leaders see gaps in how the field is adopting AI and how it reaches rural patients.
Becker’s asked four cardiovascular leaders the same question: What’s a trend in cardiology that isn’t getting enough attention?
Editor’s note: Responses have been lightly edited for length and clarity.
Johnathan Klaus. Consulting Director of Cardiovascular Services at South Shore Hospital (South Weymouth, Mass.): Where LLMs and AI really excel is digesting huge amounts of unstructured data, like what we find in a patient’s chart. Where AI can really excel, at present, is diving into patients’ charts and looking for risk categories to target prevention. This can be especially in highlighting social challenges of patient compliance that a clinician might miss. Heart failure patients with unstable housing or limited income may be at risk for skipping medications due to cost; they may have issues complying with dietary modifications due to availability of grocery stores or the cost of fresh food. AI can not only highlight those challenges but also search for available solutions and support to offer the patients. There is a large opportunity to prevent exacerbations of chronic conditions using AI that would be embedded in patient charts.
I’ll also add that there’s an underdeveloped component. Ambient AI for physicians is great. Ambient AI for nurses is very poor. On a daily basis, nurses have more contact with patients than physicians do and often elicit more background information than physicians are able to. However, ambient AI for nurses is poorly developed. Most AI solutions for nurses do not support nursing practice — rather the opposite. They only drive nursing to do checklists. You don’t need AI to do that, and you certainly don’t need a nursing degree to do a checklist. There is a lot of opportunity for health systems to really support nurses and patient care, but from what I have seen so far, the investment in this area has been largely misguided.
Jeffrey Marshall, MD. Retired Chief of Cardiology at Northside Hospital Heart Institute (Atlanta): What’s not getting enough attention is that there’s almost an assault on the financial side of how AI is reimbursed. Physician reimbursement — the physician fee schedule — is a single pie; it’s not getting larger, though I hope groups like the American College of Cardiology and its Health Affairs Committee can move Congress and government to change that. What happens is this software as a service eats into that pie, and not many people recognize that. If the pie is being eaten into by something that software as a service does independently, at $900 a click, let’s say, that erodes the pie, so physician reimbursement is adversely affected. Very few people know about that tsunami that’s out there that we’re all going to have to face. We’re going to have to get our hands around that and come up with some innovative solutions so we don’t kill the goose that laid the golden egg.
Kevin McIntyre. Senior Director, Physician Practices at Baptist Health-Cardiovascular Associates and Baptist Health Medical Group (Montgomery, Ala.): How to serve patients in rural areas. So there was a study where over 50% of counties in the United States don’t have access to a cardiologist, but how do we overcome that? And I think something that we’re getting to do is partner with some smaller facilities in rural areas under different arrangements that we can, as a practice in a larger city, recruit well-trained cardiologists, and then have those physicians outreach to those areas a couple of days a week and staff their cardiology programs in that manner. These programs have a very hard time recruiting and retaining cardiologists. They’ll have one for a couple years, and they leave to go to a bigger city. There’s really not great continuity, and so what we’re really trying to do is recruit to a larger city, have those physicians travel to those areas, but can still maintain a bigger city life while serving rural populations.
Karen Walker, MSN, RN. Enterprise Director for Cardiovascular Services at Santa Clara Valley Healthcare (San Jose, Calif.): I think looking at the facility and looking at their operational readiness for the innovation for the AI tool. We have to make sure that the organization is ready culturally to adopt artificial intelligence. Because we jump right in, and we are rapidly adopting advanced imaging because radiology was pretty much the first to adopt AI and integrate that into reading X-rays, etc. In cardiology, we’re rapidly adopting advanced imaging, adopting structural heart procedures, remote monitoring and integrating AI into this with AI-enabled tools. But many organizations haven’t redesigned their workflows. They haven’t redesigned their staffing models or even their referral patterns, because now that you’re adopting AI, the referral process and the referral patterns will be quite different. So I think certainly the operational readiness for the innovation at that particular organization or facility is key before you bring anything into an organization.
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