The good, the bad and the cautious: 1 chief medical officer on using AI in hospitals

Meera Udayakumar, MD, joined UNC Health Rex in Raleigh, N.C., in 2008 and worked her way up to medical director of several groups before finally taking over as chief medical officer in March.

"Once I started working in that first leadership position, I saw how important it was to engage physicians in making quality and performance improvements — to identify problems happening at the bedside and during the process of caring for patients, and develop solutions for those problems, rather than the other way around," she told Becker's.

For years she worked on performance and process improvement projects that exposed her to multiple aspects of the healthcare system. When her longtime mentor left the CMO role, Dr. Udayakumar was interested in the role. "I felt it would give me the ability to have a greater impact on patient care and also the process of how we deliver care to patients," she said.

Here, Dr. Udayakumar — who was hired in March — discusses some of her priorities and projects in her new role.

Question: What's the greatest challenge facing physicians right now?

Dr. Meera Udayakumar: The increasing administrative demand that's being placed on us, including paperwork and electronic medical record management. That requires valuable time that could be spent at the bedside with patients or speaking with caregivers. Balancing that demand while still delivering high quality care is a true challenge.

Q: What concerns you most about the healthcare field?

MU: One of my main concerns is the growing shortage of healthcare professionals across all worlds. Access to healthcare is another concern and that doesn't just include getting an appointment, which is challenging in itself, but actually being able to physically get to the appointment, and to be able to afford the recommended treatment. That access issue is magnified in certain fields such as behavioral health and I'd say especially so in children compared to adults. 

Another concern I have is appropriate investment and deployment of technology. Technology can absolutely make our care safer and more efficient, but it can also increase our workload. So it's important to understand and be thoughtful about the downstream consequences when new technologies are brought in.

Q: What new technology, innovation or research are you most excited about?

MU: I'm most excited about artificial intelligence and machine learning as a way to analyze large quantities of clinical data and help make clinical predictions. I'm also excited about the use of precision medicine to tailor care for individual patients based on specific factors.

I'm excited about the possibilities for AI to predict falls, delirium or agitation and behavioral patterns for deescalation or intervention. I think chronic disease management is another exciting area with potentially the ability to improve communication that's flowing between the patient and the care team.

Q: What's something your hospital/system is doing that you're most proud of?

MU: I'm proud that UNC Health is a national leader in healthcare innovation. Fortune magazine actually named UNC Health as one of America's most innovative companies to work at, and I believe that honor was based on the many ways we have leveraged technology to address problems, including administrative workload for physicians. To that end, UNC Health is working with Epic and Microsoft to develop generative artificial intelligence tools that hopefully will reduce that burden. We are fortunate to be part of the early adopter group and be able to determine how AI is used safely in healthcare.

I'm also proud of our work with hospital at home, which has scaled up very quickly. We've served over 1,100 patients in that care model with excellent patient and caregiver experience scores and clinical outcomes. We've also implemented virtual telepsychiatry consultation services to address the growing number of patients who need behavioral health services, and lastly, we've developed a virtual nursing program at UNC Health Rex to reduce the workload for the bedside nurse.

Q: What's the best leadership advice you've received?

MU: Leadership is a responsibility much more so than an opportunity. Leadership is not about being in charge or being right: The priority is supporting the needs of those who you are leading.

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