How City of Hope uses AI across its ecosystem

The City of Hope health system is aiming to transform cancer care, and the organization is using artificial intelligence in research and in other ways.

Simon Nazarian, City of Hope’s executive vice president and chief digital and technology officer, talked with Chief Healthcare Executive® about AI in a conversation at the Fairmont Hotel in Chicago, while he was attending the Becker’s Healthcare 16th annual meeting.

“We use artificial intelligence at City of Hope, across our overall ecosystem,” Nazarian says.

“In research specifically, we really use it in order to be able to create all the necessary permutations in order to determine the right approach to precision health, and really be able to create the right therapies for our patients, right, based on all the information that we have on them and their longitudinal view that we've built over a period of time.”

City of Hope is also using AI in clinical areas, he says.

“We really not only are a research organization, but we're also a care delivery organization, so really we want to be able to facilitate a bench-to-bed-to-bench ecosystem for us within City of Hope,” Nazarian says.

City of Hope has been using ambient documentation tools, which utilize AI technology to record and summarize physicians’ conversations with patients. More health systems are using AI-powered documentation tools to help doctors reduce the amount of time they are spending on updating patient health records. The tools also allow doctors to have more natural conversations as they can look at patients face-to-face, rather than trying to talk while typing into a computer.

But City of Hope is also using AI to ease onboarding for patients, and to provide doctors with more concise summaries of records before meeting a patient. Patients may have thousands of pages of notes in their records, and City of Hope is using AI to help bring the most relevant information to doctors.

“We are able to take those and use artificial intelligence to really create the right summarization of all of that information for the physician. So we save a lot of time for our physicians in preparation for our patients,” Nazarian says.

City of Hope has also developed AI capabilities to allow doctors to simply ask for certain information in the patient records. He says that the tools are saving doctors time on documenting records - often ruefully described as “pajama time” - and are offering more support at the point of care.

The system is also using AI tools to help identify patients eligible for clinical trials and which clinical trials are best suited for particular patients, he says. And Nazarian says this is improving and accelerating research while also improving care for patients.

As more health systems explore and test AI technology, Nazarian says organizations should first consider how they are using those tools rather than simply picking up the latest solution.

“Like any technology, number one, you want to make sure that you know what the problem is, you know, that you're solving: what is it, and what is the impact that I want to deliver,” Nazarian says.

Health systems also need to have careful consideration in governance for examining AI technology, developing safeguards, and deploying new tools.

“It's not something you sprinkle on or you bolt on,” Nazarian says. “You actually have to build it in. And as you go through the testing, you want to make sure that you have the human in the loop. You want to make sure that you have the right people looking at it as you go through, and you continually monitor the end results of the work.”

“You have to make sure you stay true to it, and your governance is going to be very, very important,” he says.

At City of Hope, the governance isn’t meant to be a “policing function,” but it’s meant to be an enabler for innovative ideas, Nazarian says.

“Innovation really is invisible when it's really well done,” Nazarian says. “Because what it does, it improves access, it's able to really allow our physicians to practice at the top of the license by reducing administrative burden in everything that they do, and operationally be able to continuously move us forward at the top of our game.”

(Nicole Jussen interviewed Simon Nazarian in Chicago.)