AI at CommonSpirit: 230 tools, $100M impact

With 230 AI applications live across its hospitals, Chicago-based CommonSpirit Health is setting a benchmark for thoughtful AI adoption in healthcare, CIO Daniel Barchi told Becker’s.

“Two years ago, we had about 160 applications. Now we have about 230 AI applications that are live. We’re probably generating north of $100 million annually using AI and RPA tools in a number of different areas,” Mr. Barchi said. “But before we got to that point, we put governance in place to make sure we were thoughtful about how we were using AI, particularly because patient safety, patient lives and patient data are at stake in all of this.”

Mr. Barchi said CommonSpirit’s AI governance rests on three pillars: transparency, structured oversight, and operational monitoring. The system’s Ethics, Data, Algorithm, and Governance Committee, or EDAG, meets every two weeks to review new tools and algorithms. Its members include nurses, physicians, researchers, legal and risk professionals, ethicists, and privacy and compliance leaders. Not every proposal receives approval.

“We’ve said no to a number of different things, so it proves that it’s a viable and good safety system,” he said. “And we have an operational dashboard that we use to monitor the number of tools we have, live, the risk from each one of them…how many projects are being reviewed by EDAG, how many have been rejected?”

Mr. Barchi emphasized a cautious, phased approach to AI adoption, beginning with back-office applications and gradually expanding to patient-facing clinical tools. 

“We started in the back office with billing invoices and a little bit of phone work…then we moved up to employee engagement…then patient engagement…only after we developed this framework and this level of experience and risk mitigation using AI did we get into clinical support,” he said.

Even as AI adoption grows, CommonSpirit will not pursue autonomous diagnosis or decision-making, keeping clinicians “in the loop between the AI tool or algorithm and the patient,” Mr. Barchi said.

Mr. Barchi described the system’s guiding philosophy as putting the patient first and reframing risk as opportunity. 

“If we use AI, we do a 29% better job of detecting breast cancer. Are there risks?…But we shouldn’t not use the tool if there’s an opportunity to do a better job,” he said.

He also emphasized that AI is not a replacement for people but a tool to augment clinical care. 

“AI is novel in that it produces digestible information for the clinicians at the moment that they need it most. And AI is going to remain an assistant, an insight generator and a productivity enhancer,” he said.

Looking ahead, Mr. Barchi said AI governance in healthcare will become more integrated into routine processes. 

“As we get more comfortable with AI, it will counterintuitively allow us to use more routine and safe ways of approaching it,” he said.

Mr. Barchi said CommonSpirit’s overarching goal is to ensure AI supports high-quality, compassionate care while maintaining trust and safety.

“We need to think about [AI] as a member of our clinical team that our clinicians use to make them better at what they do. And if we think about governance, it’s not just about policies, it’s about the people and the processes and a clear path of accountability for how we use these tools,” he said.

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