Three Disruptive Clinical Innovations Could Shape the Next Decade in Health Care

This Clinician's View is written by Victor Herrera, MD, chief clinical officer for the AdventHealth Central Florida Division.

From a rapidly growing population in need of our services to a shrinking workforce under increased stress, health care systems across the nation face access challenges that will impact our work for years to come. In fact, while the 65 and older population is expected to grow by 34.1% in the next decade, the U.S. will face a shortage of up to 86,000 physicians by 2036 according to the latest projections from the Association of American Medical Colleges (AAMC). This dilemma is further compounded by the increase in burnout amongst health care providers, which surged during the COVID-19 pandemic and remains high today, with 49% of physicians saying they felt burned out in Medscape’s most recent Physician Burnout & Depression Report. Here in Central Florida, the situation is especially acute as we are home to one of the nation’s top five fastest growing areas, adding more than 54,000 residents from 2022 to 2023 alone.

As the leader of clinical operations for one of the nation’s largest and most comprehensive health systems, I am charged with ensuring we keep our patients safe while delivering clinical excellence and protecting our teams — a responsibility I willingly accept but an increasingly difficult task given the obstacles. In exploring potential solutions to help plan and prepare for the future, I believe we must embrace and encourage innovation. Three current disruptors stand out for their potential to revolutionize patient care, treatment outcomes and the efficiency of health care delivery: GLP-1 weight loss agents, artificial intelligence (AI) technologies and personalized medicine.

Keeping People Healthy and Preventing Chronic Disease — the Rise of GLP-1 Weight Loss Agents

In our efforts to manage demand for health care services, interventions to mitigate chronic diseases, especially in high-risk populations, play a key role. Groundbreaking therapeutic innovations like the recently approved GLP-1 (glucagon-like peptide 1) drugs could radically change the health care trajectory, challenging both traditional treatments and the historical incidence of diseases.

Obesity currently affects four out of 10 Americans, and obesity-related conditions, including heart disease, stroke, type 2 diabetes, and certain types of cancer, are among the leading causes of preventable, premature death in our country. Additionally, obesity increases the risk of developing other medical issues like asthma, sleep apnea, osteoarthritis and gallbladder disease.

While initially developed as a new treatment approach for diabetes, the GLP-1 drugs have rapidly gained attention for their positive impact on obesity and weight loss. However, they are also showcasing promising benefits in reducing cardiovascular risks, renal dysfunction and the cascade of diseases caused by obesity. Their mechanism, mimicking an intestinal hormone that prompts insulin release post-meal, is a beacon of hope for millions striving for a healthier future. Down the road, this could fundamentally shift health care services needed, decreasing demand for things like bariatric weight-loss surgery, cardiac catheterization, stroke care, kidney dialysis and knee replacement surgeries just to name a few.

Improving Efficiency and Alleviating Stressors — the Automation Revolution in Health Care Tasks

From administrative burdens to diagnostic processes, automation is set to streamline operations like never before. AI-driven systems are already demonstrating their prowess in enhancing diagnostic accuracy, reducing errors and freeing up precious time for health care professionals to focus on what matters most—patient care. This shift is not just about efficiency; it's about transforming the very fabric of health care delivery.

At AdventHealth, we believe AI should augment, not replace, health care professionals. As the digital health care landscape evolves, the integration of these technologies holds unprecedented potential to enhance patient care, streamline processes and unlock innovative treatment methodologies. However, this incredible potential comes with a profound responsibility to ensure the benefits of any innovation outweigh the risks and that they are implemented in an ethical, secure and equitable manner.

In the 2024 Medscape Physician Burnout & Depression Report, the volume of work-related bureaucratic tasks was cited by 62% of physicians surveyed as the primary reason for burnout. Within our own system, we know that physicians report spending up to 30% of their time during a patient visit typing into the electronic health record (EHR) for documentation purposes. Not only is this burdensome it reduces the ability to develop meaningful connections with patients. That is why AdventHealth recently introduced an AI-based automated clinical documentation application into our ambulatory practices. This ambient listening tool automatically, securely and efficiently creates draft clinical notes during the patient exam for immediate clinical review and completion by the provider afterward. Our goal is to provide our physicians administrative relief while also empowering them to focus on what they love and do best—deliver exceptional patient care. We believe this new approach will also improve clinic efficiency while enhancing the patient experience—a win for all.

AdventHealth only implements AI tools like this after a thorough vetting and with support from those who will be using the technology. We have established a companywide AI Advisory Board that consists of clinical leaders from multiple disciplines to guide our efforts. By having these conversations in a facilitated environment, we can help leaders make sense of the noise and better support a responsible path forward. We want to leverage AI in a way that helps our physicians do their jobs, ensures patient safety and privacy, and ultimately, enhances the high-quality, personalized, whole person care we provide.

Because of our leadership in this area, AdventHealth is now part of a select group of organizations leading the national conversation on the responsible use of AI in health care:

• We are a founding member of the Coalition for Health AI (CHAI), a diverse group that has united leading health care providers, technology companies and academic institutions to establish best practices for AI development and implementation. Both the Food & Drug Administration and the Office of the National Coordinator for Health Information Technology are part of this effort along with industry leaders like Johns Hopkins Medicine, Mayo Clinic, Amazon, Google and Microsoft.
• AdventHealth also serves as a founding member of the Trustworthy, Responsible AI Network (TRAIN), a consortium of health care leaders striving to make safe and effective AI accessible by sharing best practices, developing tools to measure AI effectiveness in health care, creating a registry for sharing information on AI algorithms and operationalizing responsible AI principles recommended by CHAI.

Providing Customized Care — the Personalized Medicine Paradigm

Thanks to advances in genomics and biotechnology, the one-size-fits-all approach to medicine is giving way to tailored treatment strategies. Just this past December, the U.S. Food and Drug Administration (FDA) approved Casgevy and Lyfgenia, revolutionary new treatments for sickle cell disease. These cell-based gene therapies are made from patients’ own blood stem cells, which are modified and reintroduced as a one-time, single-dose infusion through a hematopoietic stem cell transplant.

As physicians, we commit to caring for one patient at a time. Personalized medicine models like these new gene therapies are poised to offer treatments that are as unique as the individuals receiving them, optimizing therapeutic effectiveness and minimizing adverse effects. This bespoke approach, leveraging individual genetic profiles, is set to revolutionize treatment plans across a myriad of conditions, from cancer to chronic diseases. At AdventHealth, our researchers are exploring several potential new treatment options within this realm:

• Under the leadership of principal investigator Guru Sonpavde, MD, AdventHealth Cancer Institute (AHCI) is among the first sites in the world and the only in Florida to offer a new, global Phase II clinical trial to evaluate the efficacy and safety of pembrolizumab plus V940 (mRNA-4157) in patients with high-risk, muscle-invasive urothelial carcinoma (MIUC) of the bladder and upper urinary tract following radical resection. V940 is a novel, customized immunotherapy that consists of mRNA that encodes up to 34 neoantigens (new mutated proteins) found specifically in an individual patient’s tumor. The mRNA is customized after molecular DNA and RNA analysis of the tumor and blood from each patient. A precision immunotherapy, the mRNA product is designed to activate the immune system to target these neoantigens.
• AHCI gastrointestinal oncologist Mohamedtaki Tejani, MD, and researchers at the AdventHealth Research Institute are leading several clinical trials to explore the effectiveness and impact of different types of ctDNA testing for the management of colorectal cancer. This transformative new technology could provide a more personalized approach to patient care, reducing or eliminating the use of adjacent chemotherapy and detecting changes earlier to make prompt treatment adjustments.

Innovation Holds the Key to Sustainability

Today we’re seeing medical advancements I never dreamed I would witness in my lifetime. Whether its uncovering better approaches to preventing disease, reducing administrative burdens or developing more effective, targeted treatments, innovation has always been essential to health care. With the challenges we are already experiencing today compounded by those that loom on the horizon, we must continue to make it a cornerstone of our daily practice and evolution.