How AI Technology Can Empower Patients

How AI Technology Can Empower Patients

What can happen if you combine a nurse’s empathy, scientific aptitude, expertise in managing medications, and patient communication skills with cutting-edge artificial intelligence (AI) technology? Tara Herington, RN, and VP of Cardinal Health Sonexus™ Access and Patient Support , says that this combination is already empowering patients with chronic illnesses… and this is just the beginning.

DailyNurse met with Tara to learn how she uses AI to help improve care at Sonexus™, which she has described as “a patient services hub that works on behalf of pharmaceutical manufacturers to remove obstacles to care and help patients forge a clearer path on their treatment journey.”

DailyNurse: You began your career as an RN, right?

Tara Herington: “Yes, I started as many nurses do, working on a med-surg floor at a hospital. Additionally, I worked in homecare and hospice before transitioning over to the pharmaceutical side of the world.”  

DN: What drew you to the pharmaceutical field?

TH: “It was something that I always found intriguing. My father was a pharmacist before he was a physician, so the healthcare field was always in my blood. One of the things that attracted me to pharma is the ability to work closely with patients in a way that was different than bedside care. For me, it created a forum for amplifying my ability to positively impact patients.  My first job in pharma was in a QA lab, working with patients and interviewing them to find out whether there were potential quality issues with their medication. The company I worked for specifically hired nurses for our ability to connect with patients and ask the [right] questions to get to the heart of the problem.”

“One of the things that nurses do well is looking at big pools of data
differently than other people do to figure out what is going on.”

DN: And now, you’re employing some very advanced healthcare technology. Aren’t you working on artificial intelligence (AI) applications?

TH: “Yes; machine learning. It’s funny, I think there are people who feel like nursing and data science don’t have much in common. But when you go back to our roots, and you look at Florence Nightingale—well, she was a highly influential statistician—so [data has] always been a part of nursing. In fact, one of the things that nurses do well is looking at big pools of data differently than other people do to figure out what is going on. By interpreting data through the lens of a clinician, new insights can be illuminated to improve patient care.”

DN: And patient education—another focus of yours—is also a vital part of nursing.

TH: “You have to make sure that people understand the medication they’re taking, the side effects, the benefits, and confirm that they’re good candidates for their prescribed medication. But then, you also need to educate them about their disease and how the medication is working to treat their disease. A lot of patient education is about patient empowerment and helping patients make decisions for their own health.”

DN: How are you using AI to further some of your goals?

TH: “We’ve invested in our technological capabilities to make sure that we can support patients in the best possible way. So, our nurse navigators use things like interaction analytics [the process of uncovering meaningful insights from unstructured natural language conversations], machine learning, and AI to offer robust support for patients and their families.

“The AI program can pick words and phrases—like the ones a nurse listens for—and process that data to identify information that may not be directly conveyed.”

An example of this is natural language processing (NLP), which helps our nurses better understand what a patient is experiencing. It allows us to be virtual detectives by uncovering hidden barriers. NLP exposes clues to determine what is going on with patients.  Using NLP, we can comb through recorded phone calls to detect things like stress, or to look for particular words or phrases, to help us understand what patients are experiencing.

The AI program can pick words and phrases—like the ones a nurse listens for—and process that data to identify information that may not be directly conveyed.

When COVID first hit, we activated our NLP capabilities to listen for patients who were mentioning affordability problems as patients struggled to pay for their medications. When patients used terms that referenced expense, or said “I can’t pay,” or “I lost my job,” etc., we were able to compile that data to prove that, understandably, patients were in danger of going without medication. We worked with our pharma clients who, in turn, were able to relax criteria for their free medication programs and helppatients who had lost their insurance coverage. Using [AI/machine learning] technology this way was particularly impactful for patients during the pandemic.”

DN: How has the pandemic affected your chronic care patients?

TH: “Access to care continues to be a great challenge in our country, no matter what the underlying condition. We are also seeing challenges to the caregiver support system that can hit an aging population especially hard. Even for non-COVID patients, they are feeling the effects of the pandemic through an inability to have live interactions with friends and family. Social isolation is often a bigger burden than their physical problems.”

DN: What are your biggest concerns for patients in 2021?

TH: “We talked about the accessibility challenges, especially with the caregiver and support system—I think that’s a big one. That social isolation is wearing on our patient population. In response, we’re having our nurses reach out more frequently, and reach out in different ways. For a long time, there was a perception that patients of a certain age didn’t text or use email, and we’re finding that is less of an issue now. Maybe it was true at one time, but it is lessening in 2021.  In addition to picking up the phone and calling, we can also send a text and let patients know that they haven’t been forgotten.”

DN: Are there any other issues that concern you?

TH: “I would say the one thing to add is that if patients are struggling to afford their medications, especially with this pandemic, it’s important for them to seek information because there’s almost always help available. Some 80% of people don’t even know there are assistance programs out there. For instance, at Sonexus™, we have a team of pharmacists responsible for running a free drug, non-commercial pharmacy, where we dispense medication on behalf of our pharma clients for patients who are uninsured or underinsured.”

About Tara Herington:
Tara Herington, RN, VP of Cardinal Health.

Tara Herington is the Vice President of Cardinal Health Specialty Solutions, overseeing Sonexus™ Access and Patient Support, a patient services hub that works on behalf of pharmaceutical manufacturers to provide tailored solutions based on the needs of their patients and their treatment journey.

Tara began her more than 20-year career as a registered nurse before transitioning to the business side of the pharmaceutical world which taught her the importance of keeping patients’ needs at the center of the healthcare system.

Today, Tara leads the Sonexus™ patient services hub, developing customized patient support programs for biopharmaceutical companies ranging from top 10 pharmaceutical manufacturers to emerging biotech innovators and cell and gene therapy developers.

Innovation, Artificial Intelligence, and the Bedside Nurse

Innovation, Artificial Intelligence, and the Bedside Nurse

Nurses have always played a critical role at the bedside while bearing witness to numerous changes in technology. In the past 50 years alone, the advancements seem unfathomable to nurses of the not-so-distant past such as “test-tube” babies, medical lasers, the artificial heart, genome mapping, CT and MRI imaging, angioplasty, dialysis, endoscopic procedures, bionic prosthetics, the internet and health information technology (IT), the electronic health record (EHR), and robotic surgeries. However, as health care races toward telemedicine and artificial intelligence, nurses must strategically position themselves to stay relevant. 

In a recent article in Nursing Management, the author stated : “Artificial Intelligence (AI) is a branch of computer science dealing with the simulation of intelligent behavior in computers. Combining the experience, knowledge, and human touch of clinicians with the power of AI will improve the quality of patient care and lower its cost.” While most nurses have been immersed in the EHR for a decade (or more, depending on the organization), the industry still struggles with quality vs. quantity of input data that will allow for valid information mining, utilizing AI to identify areas of risk, or even the pending decline of a patient.

However, the question of quality data is often reviewed by those who are responsible for an organization’s health care IT. Many nurses who jumped into the AI and innovative world of informatics struggle with orchestrating what constitutes valuable data the bedside nurse is required to input versus each discipline’s desire to have the information captured. For example, while it is important to the dietician to know which brand of tube feeding was administered to the patient, does it truly add value enough to warrant one more line on the 1,000+ EHR rows for the nurse to capture? Preserving documentation requirements to the essential data points will not only help bedside nurses save precious time, but also allow for predictability models to work in the background to anticipate patients who may decline.

Bedside nurses are the key to AI as it relates to predictability models and telemedicine. Data points such as temperature, blood pressure, and physical assessment values, entered into the EHR in a timely manner, can literally make the difference between life and death as the health information technology is scanning thousands of factors to provide outcome information. Getting nurses onboard with real-time, accurate documentation (not just copying the assessment from the previous shift) is essential. “Nurses are viewing AI as telling them what to do instead of using the insights AI provides as part of their clinical decision,” states Dan Weberg, PhD, RN. “In order for nurses to stay relevant, we need to figure a way to incorporate new technology directly into practice. AI isn’t making decisions for us as nurses, it’s making us super nurses!”

Dr. Weberg, who has worked as an innovation specialist for multiple health systems and academic institutions across the U.S., states that nurses need to demand a seat at the innovation table. Each year, more and more institutions are developing smart health apps that directly affect nursing. Yet the absence of the nurse in the concept and design is palpable. Many times, nurses are not brought into a project until it is time to implement the technology, which is a challenging time to make any nurse-recommended changes. When technology is designed and implemented without nursing input, workarounds are created, which can lead to the innovation not being used to its full capacity.

The lack of enthusiasm and embracement of technology may start in nursing schools, according to Dr. Weberg. “There is a gap between the traditional, old-school methods of teaching students how to be nurses and actual innovation in practice. Academia needs to foster a healthy relationship between nursing and advancing technology if we want to remain relevant.” One would assume that as nurses are sworn to advocate for and protect patients, embracing technology that improves patient outcomes should be obvious.

When artificial intelligence and modern technology are infused with the art of medicine, patients are safer. In a study conducted by the Institute of Medicine in 2000, it was found that 10% of medical diagnoses were wrong. The report, called To Err is Human, called for technological advances such as physician order entry to reduce the guessing game in deciphering clinician handwriting. Since that report nearly 20 years ago, many studies have proven that there are less medication errors, less adverse drug reactions, and improved compliance to evidence-based practice guidelines with the integration of health information technology.

As health care technology continues to evolve at a rapid pace, it is not just the encompassing profession of nursing that needs to be in on the change. Bedside nurses can strive to become “super users” in their departments as subject-matter experts in any technology or innovation that is being designed and implemented. Staying one step ahead and developing a mindset of improvement and innovation can be powerful. For the nurses who complain that “things are always changing too much” who long for the trifold, 2-sided, chart-in-the-color-of-your-shift days, that ship has sailed – and good riddance. The future of nursing is aglow with the megahertz light of innovation to improve the lives of nurses, patients, and the communities we serve.