In his thought-provoking 2023 book, The Coming Wave, AI-pioneer Mustafa Suleyman singled out the application of AI in modern healthcare as perhaps the greatest contribution that developments in AI could deliver to humankind. I’ve written in the last year about how a couple healthcare leaders – Mayo Clinic and Washington University School of Medicine in St. Louis —are integrating AI capabilities into their processes.
Cleveland Clinic is a nonprofit, multispecialty academic medical center that’s recognized in the U.S. and throughout the world for its expertise and care. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States.
Among Cleveland Clinic’s 81,000 employees worldwide are more than 5,743 salaried physicians and researchers, and 20,160 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,690-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, 276 outpatient facilities. In 2023, there were 13.7 million outpatient encounters, 323,000 hospital admissions and observations, and 301,000 surgeries and procedures throughout Cleveland Clinic’s health system.
Organizing for Data, Analytics, and AI Leadership
I recently spoke with the leaders responsible for innovating healthcare through the application of data, analytics, and AI at Cleveland Clinic. Dr. Rohit Chandra is Executive Vice President and Chief Digital Officer at Cleveland Clinic. In this role, he oversees information technology, which includes data, analytics, and AI, and leads digital innovation throughout Cleveland Clinic’s global health system.
Dr. Chandra comments, “Cleveland Clinic sees great promise for artificial intelligence in healthcare, as it has the ability to improve care for patients and streamline work for caregivers”. He continues, “We believe that the thoughtful implementation of AI will enable us to scale healthcare to more patients in need, with greater safety and quality, and a better patient experience.” Dr. Chandra adds, “We also believe it will lead to higher efficiency for our clinicians, allowing them to spend more time caring for patients.” He cautions, “However, we need to be very careful about how we implement it”.
Reporting to Dr. Chandra is Albert Marinez, Cleveland Clinic’s first Chief Analytics Officer, Sarah Hatchett, Cleveland Clinic’s CIO, Vugar Zeynalov, the Cleveland Clinic CISO, and the newest member of the leadership team, Dr. Ben Shahshahani, who was named as Cleveland Clinic’s first Chief AI Officer on August 12, 2024. As the organization’s first Chief AI Officer, Dr. Shahshahani’s mandate is to direct the use of AI across the Cleveland Clinic health system. He joins Cleveland Clinic from SiriusXM and Pandora, where he served as Senior Vice President of Science, Machine Learning and Product Analytics since 2021.
Dr. Shahshahani will be working closely with clinical leaders, and data scientists, to drive Cleveland Clinic’s AI vision of transforming healthcare delivery. As Chief AI Officer, Dr. Shahshahani will lead the development and execution of an enterprise AI strategy, focusing on opportunities where AI can help transform patient care, caregiver experience, and organizational efficiencies. These efforts will be undertaken while ensuring that the use of AI puts safety first, and adheres to industry regulations, ethical considerations, and data security best practices.
As Chief Analytics Officer, Albert Marinez is responsible for the data and analytics infrastructure on which good AI is dependent. Marinez previously held similar roles at Intermountain Healthcare in Salt Lake City and Swisslog Healthcare in Denver. He comments, “Our role is to have the best Data, Analytics, and AI capability for healthcare in the world. We take that charge seriously.” Marinez notes, “We’re exploring ways AI can enhance access to our world-class providers and equip clinicians with advanced technology, allowing them more time with patients.”
Marinez elaborates, “Our Chief Analytics, and Chief AI offices are responsible for establishing Centers of Excellence, enabling and empowering federated teams across the clinic, and delivering exceptional operational value.” Marinez adds, “We’ve established an Analytics Executive Council that drives consistency in data definitions and use of data. We manage our data assets holistically, combining cyber, compliance, analytics, and legal to ensure we’re using data in the best way possible.”
Building an AI Culture through Education and Participation
Cleveland Clinic’s commitment to educating the organization on data and AI at all levels is exemplified by a recently organized inaugural annual Analytics and AI Summit. Participants included 1,000 attendees, with well over 100 physicians representing every major part of the organization. The summit featured dozens of educational sessions, including pre-recorded videos, live sessions, and empowerment for federated teams.
The leadership of Cleveland Clinic has embraced AI and is encouraging all employees to engage with it. Marinez comments, “Our strategy to integrate AI into our organization involves embedding AI into our cultural DNA. This includes educating our caregivers about AI and showcasing the innovative solutions we’re implementing and their potential to improve patient care and operational efficiency.”
Marinez elaborates, “By fostering an environment that promotes exploration and provides the necessary tools and support, we empower our clinicians to experiment with and apply AI in meaningful ways. This commitment to inspiring internal innovation demonstrates our dedication to cultivating a culture of continuous learning, collaboration, and innovation.” He adds, “This foundational step is crucial for generating new ideas.’
To navigate the utilization of AI at Cleveland Clinic, the organization has established an AI Task Force. Dr. Chandra comments, “AI is evolving rapidly, and while it has the potential to transform, we must ensure that the use of AI in a clinical setting is secure, safe, and without bias.” He elaborates, “The AI Task Force is a multidisciplinary team that governs our AI efforts to ensure we are using AI ethically, responsibly, and safely.”
The AI Task Force is designed to bring strategic focus, consistency, and transparency to the AI efforts of Cleveland Clinic. The task force undertakes activities including the evaluation of algorithms for quality, ethics, and bias, aiming to mitigate health disparities and ensure responsible AI use. Marinez notes, “Ethical considerations are critically important as we move forward, and AI applications must be equitable, transparent, and accountable.”
AI Use Cases originate from a variety of areas within the Cleveland Clinic health system, including many different clinical areas. When deciding on what programs to move forward with, a dedicated team of cross-disciplinary leaders review ideas based on a set of criteria, including potential impact, readiness for technology, and business case to be made.
Marinez explains, “We’ve established data science ‘chapters’ designed to connect and rally a larger group of interested Caregivers to discuss, debate and create new use cases to be brought to the AI Task Force.” He continues, “The teams are designed around particular subjects (i.e., LLMs) and will help the organization go deep on a particular subject, helping to facilitate innovation and funnel the right use cases forward.”
Applying AI in Patient Care through Guiding Complex Brain Surgery
Cleveland Clinic envisions ways in which AI can lead to breakthroughs in patient care. AI and machine learning are revolutionizing the way large volumes of patient data are interpreted. An emerging patient care application is the use of AI in guiding complex brain surgery, leading to more precise epilepsy surgical planning.
Cleveland Clinic’s epilepsy team is using advanced imaging and AI to help locate the source of seizures. Epileptic seizures are caused by abnormal electrical activity in the brain, so neurologists need to locate the source of that abnormal activity. Brain lesions may be the cause of seizures and removing these lesions can give patients a cure for epilepsy. The team uses AI algorithms that analyze the individual patient’s MRI data to compare with a large amount of healthy control data, to pinpoint the location of subtle brain lesions.
By knowing the exact origin, neurosurgeons can more precisely remove brain tissue associated with seizures, which can help the patient become seizure-free. Experts have been able to take images from AI-assisted advanced imaging to better identify epileptic lesions that would not traditionally be seen on the MRI. This is helpful in patients with hard to locate seizure origins, and in patients with multiple, extensive lesions where traditional MRI could not provide further localizing clue.
The Cleveland Clinic team is also spearheading an innovative signal dynamics-based approach to investigate intracranial EEG recordings using sophisticated neuro-engineering methods coupled with machine learning algorithms. This AI-inspired approach aims to improve visualization and identification of brain networks involved in early onset and spread of seizure dynamics, to better inform surgical decision-making and planning.
Irene Wang, PhD, Staff Scientist and Research Director at Cleveland Clinic’s Epilepsy Center comments, “A useful AI model can have a lasting impact across the country and beyond by improving epilepsy seizure outcomes and increasing the number of patients who can be deemed favorable candidates for potentially curative surgery.”
Applying AI for Operational Efficiency, Research, and Drug Discovery
Cleveland Clinic sees multiple opportunities for AI to improve operational efficiency, research, and drug discovery.
In the area of operational efficiency, Cleveland Clinic is applying AI to run its business smarter and more efficiently, through the creation of a Virtual Command Center, developed in collaboration with Palantir. The Virtual Command Center creates a common operating picture across teams for current and future hospital status, using real-time data to better forecast bed availability, patient admissions, staffing levels, and wait-times to provide greater access for patients.
Using the Virtual Command Center, Cleveland Clinic now has an accurate prediction of how many patients will be coming into the hospital in the next 24 hours and can create a better plan for staffing. Cleveland Clinic has achieved a 7% increase in daily hospital transfer admissions at the main campus over the past year. This results in patients getting needed care faster.
AI will also allow caregivers to spend less time entering data and retrieving data from systems and more time caring for patients. Cleveland Clinic is currently piloting ambient listening software. This AI technology can listen to patient appointments and generate notes for the physician directly into the medical record. While the physician still reviews notes, the tool saves clinicians valuable time in contrast to the traditional data entry required after each patient visit.
AI is accelerating the pace of medical research in a variety of ways. One example is the use of AI for drug discovery. In one research lab, scientists are using high-performance computing and AI algorithms to analyze massive amounts of data to find potential new or existing drugs to help people with a variety of conditions.
Through intelligent computer-based systems and other analytic tools, Cleveland Clinic researchers search databases of human gene sequences and molecular targets of existing drugs to uncover how well these drugs may treat complex diseases such as Alzheimer’s. These researchers are using AI algorithms to canvas massive amounts of data on FDA-approved drugs to uncover if they be effective against other challenging diseases.
Improving Healthcare in an AI Future
Reflecting on healthcare in an AI future, Cleveland Clinic’s Marinez proclaims, “We’re doing it now! We’re investing heavily in new and emerging AI roles and solidifying our current operations.” He continues, “In addition, we’re continuously developing new AI applications, scaling up successful pilot projects and collaborating with external partners, such as technology companies and academic institutions, to leverage their expertise and resources.”
Marinez elaborates, “Our collaboration with external innovators is driven by key principles. We look for solutions that tackle real challenges and are ethically sound and unbiased.” He continues, “We are focused on identifying high-value use cases where AI can have a significant impact on our caregivers, whether by improving patient outcomes, enhancing diagnostic accuracy, or increasing operational efficiency. This focus helps us direct our resources and efforts toward areas with the highest potential benefits.”
These combined efforts are ensuring that Cleveland Clinic not only stays at the forefront of healthcare innovation but also sets a standard in adopting and applying AI to enhance both patient care and operational excellence. Marinez concludes, “This approach underscores our dedication to leading in healthcare technology, not just keeping up with change but driving it, forging new paths, and shaping the future through continuous innovation and collaboration.”