The anticipated challenges of AI technology

CIO Curt Cole uncovers the biggest challenge facing the virtuous cycle. 

Curt Cole, MD, is the chief information officer and an associate professor of clinical medicine at New York City-based Weill Cornell Medicine. 

Dr. Cole will serve on the panel "Evolving Technology, Disruptors and Regulatory Issues in HIT and How to Know What to Invest In" at Becker's 7th Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place Oct. 4-7 in Chicago. 

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Question: What are you most excited about right now?

Dr. Curt Cole: I am most excited by what we are poised to do with data. For the last several decades, we have been building workflow systems, first one discipline at a time and now across multiple disciplines. We still have a lot of work to do optimizing, but now we are generating data in quantity with the modest quality too. The next challenge is integrating the data in useful ways to provide feedback to the clinic to set up a virtuous cycle of incremental improvement in process, system and data.

Q: What challenges do you anticipate over the next two years?

CC: The biggest challenge in setting up that virtuous cycle is learning how to structure and use the data. It is tough to do well because you have to know a lot about the process you are optimizing, how the data is being captured in the system and how it is subsequently engineered. Only then can you analyze and interpret the data. 

In some ways, the many fumbles with AI technology are large and expensive examples of messing up one or more of these steps. Arrogantly assuming you can interpret data you don't understand will lead to failure at best — and since this is medicine, it can also lead to tragedy. 

Q: Where are the best opportunities for disruption in healthcare today?

CC: What Uwe Reinhardt said two decades ago is still true, "It's the prices, stupid." I have to get a screening endoscopy every few years, so I'm acutely aware of how prices for that procedure have changed over the last few decades. My last one cost over $15,000, five times the cost of the previous one just a few years ago. And the provider who did it claims they are losing money — a genuine accomplishment! Everyone knows that cost structures and prices are insane in the U.S. Unfortunately, healthcare technology is generally used to raise prices, not lower them. It doesn't have to be that way — and the provocateur Mark Cuban's drug company is one example. Providing high-quality care at low prices is totally possible, and our newest technologies can help. But everyone, even the "nonprofits," has gotten so greedy that very few try. And I bet that most new technologies will be used for greed, not good. 

Q: How is your role as CIO evolving? How are IT teams changing?

CC: We were early EHR adopters, so I have had the luxury of moving away from the mundane torture of implementation to focus on research and innovation. Inside my department, the focus is always on process improvement internally and for the missions we serve. I spend more time thinking about optimizing the experience for my staff and our users. Especially with COVID, morale is a huge focus. And our institution has made diversity a very high priority. For me, the key to all of the above is focusing on individual recognition, growth and development. As a faculty member, I see what we do for students, and I'm very committed to extending that orientation to our staff.

One example is my work at CornellTech; our new engineering school focused on entrepreneurship. There, I get to advise new companies with a real shot at changing care. I try to connect the students to our IT staff so they can learn from clinical experts and those who know the systems and the data. Obviously, this is good for students, but it is great for the staff too. A lot of the magic of academic medicine comes from having new students re-ask fundamental questions year after year. That's good for faculty and good for staff. It keeps us grounded while constantly questioning why we do what we do.

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