Healthcare Innovation (HCI): What has had the greatest impact on Hartford HealthCare’s patient safety improvements?

Kumar: It requires discipline and organizational design. We identified core principles, driven by leadership, and committed to becoming one of the best organizations in the country for safety and quality. We have standardized protocols and procedures through councils across the system.

Accountability matters, but it also means coaching, teaching and mentoring people, making sure they have the right tools, and building a just culture into the process. We’ve invested in resources and training. Most important, clinical teams come together through the councils to debate issues and reach decisions. That has been a fundamental change for us.

The AHA considered more than quality scores. It also looked at our culture, cost-conscious care, innovation, health equity and how we manage harm events. The award reflects work across all those areas.

HCI: How does the clinically integrated network align clinicians around quality goals?

Premkumar: Close to 4,400 clinicians are part of our network. We’ve worked to set clear population health goals and quality measures across the organization. For example, we’ve established priorities for hypertension and diabetes by ZIP code, with kidney health among our core measures.

We’ve also brought the measures in our value-based payer contracts together around outcomes that matter to patients. That gives our clinicians and care managers a clearer set of shared goals. We’ve seen our star ratings and patient outcomes improve year over year.

HCI: How do you share data across the network when independent clinicians use different electronic health records?

Premkumar: It has been a challenge. We’ve strengthened our membership standards so that everyone in the network is expected to contribute to quality, safety, data and analytics.

Hartford uses Epic, and we provide Epic CareLink access to clinicians who use other EHRs. We’ve also helped some independent practices move to Epic Community Connect. Regardless of which system they use, network members have standards to meet and pathways for addressing gaps. We can’t achieve shared outcomes unless everyone contributes.

HCI: Beyond patient safety, what is Hartford doing to standardize care and improve systemwide performance?

Kumar: One effort I’m proud of is clinical care design, our systemwide approach to reducing cost. We want care to be affordable, and that means looking for ways to reduce waste and variation.

Clinical care design brings clinicians together with supply chain, contracting and other groups to see where we can eliminate waste without compromising quality and safety. That is our guiding principle. We’re on track for more than $77 million in savings this year.

I see quality, safety and cost as parts of the same equation. If we can’t reduce expense, it becomes harder to invest in the quality and safety improvements our communities need.

HCI: How are you approaching patient-facing AI tools such as PatientGPT?

Premkumar: We developed PatientGPT with K Health and placed it in the MyChart portal within Epic. More than 300,000 primary care patients have access to it. It went through our quality and safety governance process, and its initial testing phases had institutional review board approval. We’re studying its quality as it rolls out across Connecticut.

Patients can use it for general health questions, clinical questions and help navigating care. Because it sits within our patient portal, it can use information already in the medical record. We believe it can recognize some urgent situations and direct patients to the emergency department. It does not continue those interactions in critical or behavioral health situations.

HCI: What have you learned from HHC 24/7, your virtual primary care platform?

Premkumar: It has been live for more than a year, and we’ve completed nearly 65,000 visits. A physician or advanced practitioner is involved in those visits. For us, the opportunity is access: patients can seek care at any time and maintain an ongoing primary care relationship.

The platform also helps us address care gaps, including breast and colorectal cancer screening. Staffing has been manageable because clinicians credentialed in multiple states can work on the platform. We now have both physicians and advanced practitioners involved.

HCI: Where are you using ambient clinical intelligence?

Kumar: We first introduced Abridge in primary care and have expanded its use to emergency departments. We’re also piloting it in nursing, where staff have found it helpful with day-to-day work.

Premkumar: We see possibilities across the clinical visit, from preparing for an appointment through documentation, coding and billing afterward. We have pilots in several of those areas. The aim is to make information easier for clinicians to use and reduce the administrative burden that can limit access to care.

HCI: How do you decide whether to work with a technology vendor or use a capability offered by Epic?

Kumar: A technology has to bring value to patients and improve clinical workflow. We’re also careful about adding to the technology burden on staff. We consider what Epic can offer and where another partner may better meet a need. We chose Abridge in part because its approach to innovation aligned with ours.

Premkumar: We’re flexible about where a solution comes from. We previously used a separate vendor for appointment reminders and messages about care gaps. When we could build that capability into the EHR, we moved it there. What matters is getting patients what they need in a timely way.

HCI: What does Hartford’s AI governance process look like?

Kumar: An executive AI governance team reviews implementation decisions, including partners, tools and the process for putting them into use. We consider both clinical and nonclinical applications.

The review is multidisciplinary. Clinicians, nurses, legal and ethics representatives examine safety and implementation questions together. Business units can bring forward ideas, and we support them when they meet the principles we’ve established.