Ep 18: Why AI Can't Replace Nurses with Dr. Amy McCarthy

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[00:00:58] Hello and welcome to the Nurse Rosas Insights Podcast. I'm your host, Nurse Rosa Hart. And today joining me is another nurse named Amy McCarthy. Now, Amy, thank you so much for being with me today. Of course. No, it's exciting to be here.

[00:01:15] So I could go on and on bragging about Amy. She has not only like over a decade of experience as an RN, she's also a DNP who is now the chief nursing officer for Hippocratic AI, which is another big exciting project all on its own. So Amy, could you share with us like your background in healthcare and really what you're to?

[00:01:39] Yeah, absolutely. So, you know, I have been in the nursing healthcare professional space for the last 12 years. My journey started as a women's and infants nurse, so I did mother-baby. I love my moms and babies. It's always a specialty that will have a very special place in my heart is getting to introduce new babies into the world. And so I did that for almost two years. But as I kind of grew in that area, I saw what was happening in nursing.

[00:02:08] And I just have such deep respect for our profession and for what we do. And I wanted to be able to advocate for nurses because when nurses have the tools that they need, when they have the work environments that are supportive and conducive to the work that they do, they're going to deliver better patient care. And so I knew that I wanted to be a part of leading that and helping to empower nurses to do that work. And so I started my career in nursing leadership, kind of the traditional realm of going through charge nurse and then supervisor and then, you know, have worked in a variety of different settings.

[00:02:38] I've worked in ambulatory. I've worked in for-profit, non-profit and academic medical centers. But I've always been predominantly in the women's and infant space, but have always tried to bring technology into that too. I was always very tapped into how can we use technology, how can we bring innovation into the space so that, again, nurses can do the work that they need to do, do so in a way that's productive and is best for the patient, but also so that they can find joy in what they're doing.

[00:03:04] And so when I got the call to serve on the nurse advisory board for Hippocratic, it was an interesting possibility. I'd never served on the advisory board for tech. I'd done a lot of work in professional associations, so I'm currently the president of the Texas Nurses Association. Yeah. I've been very involved. Yeah. In A&A. Yes. And serving in their board of directors, A1.

[00:03:30] But I'd never really taken a step in the industry, and I was really intrigued by it. And so I ended up taking up the offer and served on their advisory board for about eight months, did some work with them, just did advising how the product was created. And they ended up opening a chief nursing officer role. And at that point, I was looking to potentially pivot my career. I was looking for advancement.

[00:03:53] And I'll admit, you know, as a nurse who's worked in the traditional healthcare space for so long, it's scary to think about leaving that traditional space because it does look a little bit different. But I was excited to apply and eventually have the honor and privilege of serving in this role today. And it's been just a huge adventure. I've been in the role for about six months now.

[00:04:13] But, you know, being able to impact healthcare and nursing in a way and kind of serve as that bridge between the two worlds has been an incredible experience and one that I'm constantly learning from. So that's a little bit of our journey. So define for us a little bit what is Hippocratic AI and what is it working on? Yeah, absolutely. So Hippocratic AI is using generative AI to build AI agents.

[00:04:41] And these agents have a lot of really cool functionalities to them. So we are able to do a lot of patient-facing conversations. And so, you know, what I think about, yeah. Are you saying, are you building the AI nurse that everybody's been hearing about? Oh my gosh. So, you know, it's crazy when people bring up this term AI nurse.

[00:05:01] And, you know, it's interesting to be an industry because I will tell you that what I have learned and what I tell nurses all the time is that we have kind of a brand problem. Because the question I ask is why are people calling it an AI nurse? And, you know, I tell my team all the time. I think that's even a thing that's possible. Right. Because I know what I did as a nurse. Right.

[00:05:24] And so, you know, my team will tease me because, you know, I am very clear on that this is not a nurse. Like if you drop down and you need chest compressions, guess what? The AI agent will not be helping you with that situation. It's not going to just magically jump out of the computer and some hologram is not going to be able to do things. It's not, Rosa. It's not. It's not. It's not. It's why I shake my head when I hear industry.

[00:05:49] And it's, you know, it's people across the board that I have recognized just don't understand what we do as nurses. And so, you know, people ask me, you know, how could you enter into industry where they're calling it an AI nurse, you know, regardless of the company. Right. I mean, I've seen, you know, all different types of tech companies trying to use AI and tie it to nursing. And there's a lot of legislation right now that's being worked on around title protection. And I think that's fantastic. But I we need to do a lot of education around this.

[00:06:16] And so I do joke, you know, because people ask like, oh, you're the one who's creating this. And I'm like, no, I am. I will never be creating an AI nurse. But what I am trying to do is create an AI tool that can help nursing, that can help clinicians and augment what we're able to do. Because I think if you ask any clinician today, the work environment is not sustainable in its current form. And so how do we use technology in a very intentional way so that we can bring joy back into clinicians' lives? Right.

[00:06:44] And ensure that, you know, they're able to take care of their patients, that they're able to, you know, take care of themselves as nurses. Because I just see so many administrative tasks that we're doing today that really could, we could think about how do we, how do we start to alleviate some of this? What can technology take on safely? And what still remains in the realm of a nurse or a physician or any type of clinician? Right. And so that's the problem that I'm constantly trying to solve with our healthcare systems and partners and seeing.

[00:07:13] And that's been the fun part, honestly, Rosa, is getting to use my clinical knowledge, getting to use my expertise from the hospital space and translating it into making the use of technology very intentional. And it's not one more thing, right? It's not another thing that a nurse is having to do. It's actually starting to alleviate what a clinician is having to deal with on a day-to-day basis.

[00:07:33] Well, let's go back to your experience because you said that throughout your nursing career, you love integrating technology that's high-tech so you can be more high-touch. Are there any examples you remember from when you were at the bedside where you were incorporating a new or unfamiliar technology that made you able to have a more therapeutic relationship with your patients? Absolutely.

[00:07:59] So during the height of COVID, I was a nurse manager over a maternal fetal medicine program in Dallas. And we saw over 300 pregnant women a day, all with high-risk diagnoses and in pregnancy. And when you think about just the management of that and how many people are coming in and out, well, COVID introduced a very big challenge with that because you could not have all of those people safely, especially pregnant women, coming in on a daily basis.

[00:08:24] And so we really had to be creative with how do we revamp prenatal care? And prenatal care is one of those things that people really don't like to touch because there's so much risk around, you know, how do we take care of a woman in pregnancy? How do we make sure the baby is doing okay? But, you know, when you're dealing with the patient population, you have to look at, like, socioeconomic standards. You have to look at social determinants of health. And you have to think about, like, what might be influencing their inability to get to an appointment.

[00:08:53] Just, you know, take COVID out of the picture alone. And so it gave us the opportunity to get really creative. And so I remember working with our medical staff to say, what if we start to introduce telehealth into this? Like, how does that, how do we do that in a safe manner? Yeah. And what does that look like across the course of nine months with a high-risk patient or just with a well-pregnancy patient?

[00:09:13] And so we ended up developing over, you know, a course of time, a telehealth program where as a mom first became pregnant, we would do more telehealth visits, interspersed some in person. But we did far more check-ins. And I'll tell you what we found, Rosa, is the ability to be able to do telehealth when more people attended their appointment because they didn't have to worry about childcare. They didn't have to worry about transportation.

[00:09:35] And there was also a safety mechanism in the height of COVID, you know, being able to stay home and not be introduced to potentially COVID or other infections or diseases. And so we saw a lot of great things come from that. And I remember, you know, the staff being concerned that, oh, will people participate in that? What if they don't have the technology? And what we found is that that really wasn't a barrier in many of these cases. And so what that taught me is that sometimes we just need to trial it.

[00:10:01] You know, we need to see if it'll work and get past some of our assumptions as clinicians because, you know, we have to be a very... Are you saying we don't need to do 13 years worth of research on telehealth before we try it to make sure it's okay for us? I know it's crazy, Rosa. I know that that's crazy to think about.

[00:10:20] But yes, you know, and I will tell you, working in this space today, it's interesting because that's somewhat what I have to work with with healthcare systems is to change the culture of, I know we want to be so perfect. And it has to be wrapped up in this perfectly wrapped present with a bow neatly tied on top. But sometimes it's about how do we pilot something that, you know, has a great potential? How do we make sure we mitigate risk in the best way possible?

[00:10:49] But how do we start to work on continuous iterations? When I work with healthcare partners today, I say, listen, this may not be the perfect product in current state, but you and I are going to work together to get it to where it needs to be. But regardless, we're going to make sure that this is safe. And here's how we make sure that it's safe. And it's interesting because that is a culture shift for healthcare. But I think it's one that's going to be more and more necessary when you're looking at the implementation of AI in healthcare, because AI is different than any technology.

[00:11:18] It's not like getting a new piece of equipment for your OR. It's something that has to be constantly managed, constantly monitored. And really, when I work with healthcare systems today, it's not a one and done meeting. It's very much a partnership where we are working and co-designing and developing together to make sure that, one, the product stays safe and that it is actually useful to their clinicians. Yeah, we hear a lot about teaching the AI or training the AI to do what you need it to do.

[00:11:46] So I think you described it as more of like a conversational type question and answer type situation. Does Hippocratic AI have like an ambient listening ability or how does it look? Yeah. So we don't necessarily focus on the ambient listening space. There are many companies that are working in that space today. Ours is really using conversational AI. And so I'll give you an example of doing a post-discharge phone call, right?

[00:12:16] That's my favorite. Yes. Yes. And I will tell you, in women's and infants, I often struggled because I would send patients home after having a baby. And maybe we could do one check-in. But then I thought about how many of these moms start to really get in the midst of parenthood and dealing with emotions and hormones and all of these things and dealing with a brand new baby. And how do we provide that support after they go home?

[00:12:43] And so I've always wanted to work in the space of like developing post-discharge calls and doing a better job of having more frequent touchpoints. And so one of the things that we can do today with our AI agents is be able to facilitate some of these calls. We don't do diagnostics. What we do is we simply, the AI agent can have a conversation with the patient and say, I know that you were discharged home on this date. Do you have any questions about your discharge information?

[00:13:10] And so it has that content available to be able to go over the patient. But it also can do things like make sure the patient has gotten their medications, has gotten their durable medical equipment. You know, what are things that maybe didn't go right with your experience that a nurse leader can follow up on? And, you know, we can really build the script to be whatever questions the hospital or health care system is interested in asking. But it's really neat to see these patients engage because I'll tell you, Rosa, I'll be honest.

[00:13:37] You know, when I first started working here, I was like, will these patients really engage with an AI agent? Like, will they have these conversations? And I will tell you, some of these patients will talk to the AI agent for 30 minutes or so and just really start like going through the conversation. And what we find is, you know, we get a lot of information from that. The health care system is able to better respond to patients. And also, we're able to identify, are patients getting the medications and resources that they need? And if they're not, how do we help them?

[00:14:06] Because, you know, my main thing in doing discharge calls too is to be able to keep them out of the acute care emergency room setting, right? Because that's what we have right now is this vicious cycle with so many of our patients. They go home. They may not necessarily have the resources that they need. They're not getting a lot of that attention. They end up right back in our emergency room. So how do we start to convert our culture of sick care in the United States to really be more of a preventative care model? And I think that the use of agentic AI can really help with that.

[00:14:35] Yeah, I absolutely love this, right? Like, as a stroke navigator, what I do is call patients for follow-up after their discharge after a stroke. And so any kind of help with that would help me be able to reach more patients and be able to prioritize who do I need to spend the most time following up with or give me a checklist of what they need. Like, so I could double check, oh, did that referral for that equipment not go in? Did that referral to rehab not go in?

[00:15:03] And I can check on that before even calling them. And then when I call them, tell them, hey, this has been taken care of for you. But I do have a question about, like, if they're talking to it for 30 minutes, do they know it's not a real person? Yes. Yes, they do. So... Is it their new girlfriend? I know, right? It does beg that question. Is it their new relationships? Like, has that been an encountered issue for you? No, we have not encountered that.

[00:15:31] But one of the things that we're very transparent and strict about is the fact that the patient does know that they're talking to the AI because the AI introduces themselves as the AI care assistant or the AI agent. Gotcha. And we also make sure that when we're working with healthcare systems or clinical partners, that they are doing education upon discharge to repair that patient for that call. Oh, wow. Because we don't want that patient to go into this blindly. We don't want this to be a surprise. And we believe in the transparency behind that, right?

[00:16:01] Like, every person should have the right to say, you know what, I don't feel comfortable with this. I would like to speak to a human. And so we, within the first minute of the call, I mean, again, that is the introduction. And the patient has the ability to say, I'm just, I really want to speak to a human. And so in that case, and I will say that actually in most cases, that's less than, that's less than two or 3% of the callers. That we get.

[00:16:23] And so that has been really neat to see because what that tells me is that this has the potential to be a really successful type of tool for us to be able to use as clinicians to really extend ourselves, right? And to your point, as a stroke navigator, right? How cool would it be to be able to know before a conversation, what are the key things you need to hit on with that patient? What are the things that they need? And it's able to allow us to work smarter, you know? Work smarter, not harder. Seriously.

[00:16:50] Like, we've been wanting to clone ourselves for a long time. But if we could just, like, filter some things or essentially triage our phone calls and say, here's a list of 40 patients you need to call today. And on this list, it kind of looks like they're all the same level of urgency, right? And so it's hard to know, like, and then you call, like, 20 people and if 10 of them answer, some of them may have issues and some may just want to talk.

[00:17:17] And so you might not get to address the people who have, you know, pressing issues you could resolve because of the time spent reassuring the people who really needed that reassurance, which is also important. But if you could just, like, let people know, hey, we took care of these tasks-like things. And then you'd have more time for the relational end of things. I could definitely see that helping in my workflow. Yes. Yes. Absolutely. Absolutely.

[00:17:47] So this brings us to a billion-dollar question. Yeah. So, Dr. Amy McCarthy. Yeah. If you were given a grant for $1 billion to direct at meeting the needs that you see, how would you like to see it used strategically to have the most sustainable impact? Yeah. You know, that's a great question, Rosa. And I think there's several different ways that you can go with this question.

[00:18:17] I am going to bring it back to nursing, though, because what I'll tell you that in the six months of being in this role, what it's taught me is that we as clinicians are not taught to think about technology in the way that's needed. I mean, it's not really not a part of our basic instruction when we go into nursing school.

[00:18:33] And so what I would say is that if I had a billion dollars, I would want to work with our, you know, system, with our nursing schools to think about how do we revamp our curriculum today to make nurses not only clinically savvy, but tech savvy. And I know that that would require investments in working with tech companies. That's why in my role as chief nursing officer, I try to do a lot of work with partnering with educational institutions. So one of the most recent ones that I partnered with was Chamberlain and Walden University.

[00:19:02] It's one of the largest online nursing programs in the country. And we're co-developing curriculum around AI education, specifically geared for nurses. And I want to do more of that because I think that we tell nurses all the time to, you know, we try to empower them. We're like, you know, use your voice, use your clinical expertise and make sure you have a seat at that table.

[00:19:23] But if we don't know how to talk about this technology, if we don't know where to start with this, it makes it real hard for us to be able to advocate or even understand what that looks like. And I'm not talking about bedside nurses. I'm talking about nurse leaders, too. And so how are you going to contribute to the conversation if you don't understand the elements? Right. Right. Right. And so, you know, I believe so strongly in what nursing has to offer. I think nurses are some of the most creative people out there. They have so much knowledge and clinical expertise.

[00:19:51] And it kills me when we stay silenced because we just we there's either fear or there's just lack of knowledge. And part of that is our own doing. If we don't educate ourselves on this, if we don't, you know, in our nursing programs, in our baccalaureate, you know, just associate degree, whatever the starting point is, if we don't have some of this education and really prepare ourselves to be very savvy in this changing environment.

[00:20:17] Then then we're going to struggle to have a voice in the long term in this conversation. And so I would want to invest that money in coming up with with a program and then building something sustainable so that nursing could legitimately play a very big role in this conversation, more so than what we do today. Because I'll tell you, being the chief nursing officer of a health care tech company, it's it's a lonely place to be because there's not enough of us.

[00:20:43] And you hear that from a lot of my colleagues who are over tech companies. You know, we have to navigate both ends of this. Right. We have our nursing brain and our nursing identity. And then we have the identity of being an industry. And and that is a balancing act because I I have to figure out how the two integrate together.

[00:21:02] And, you know, I want my goal is to see more nurses in the space, because, again, the more and more I dive into this, the more I see the need for that nursing knowledge and that understanding of workflows, that understanding of just the space of health care and understanding patients. How valuable that would be to the development of technology, because like for once you would actually have technology that is conducive to your workflow. It's not that one more thing. Right. And I think that that's accomplished by bringing clinicians into this conversation. Yeah. And I think you're right.

[00:21:32] And so on the one hand, I hear the concerns of people who are, you know, who don't understand how it could not end up taking our jobs or things like that. But I always think back to like. I ended up with a lot of patients in their last days on comfort care. I did work in the ICU, but I kind of became a hospice ICU nurse because if somebody went comfort care, like they'd be like, oh, Rosa would be good for this family.

[00:22:02] Yeah. Yeah. Yeah. Which is a little heavy on my heart. But like I would have patients who didn't have any family or friends there with them, whether or not they had them and they weren't just available or whatever. And I don't want to leave anyone to, you know, pass away in their last moments alone.

[00:22:19] So like I remember sitting with my computer on wheels at their bedside of this one man and I'm holding his hand with my left hand and charting with my right hand because I'm not going to leave him alone. And there's the last hour of my shift and all my tasks are done and I have to chart them or I didn't do them. Right. And if I don't get it charted, then I can't leave. Right. Right. Right.

[00:22:45] And so I just know that if there was some kind of hands off way that I could have documented my activities, then it would have allowed me to be so much more like present. And maybe instead of just sitting there holding their hand, maybe I would be able to like sing or something, you know, more human than just halfway giving attention because I have to halfway chart over here.

[00:23:12] And so I really love the idea of embracing high tech so that we can be more high touch. And so working towards that goal, I'm definitely in favor of. Yeah. And what a wonderful example. Yeah. I mean, and that's it's funny you bring up that example because it's an example that I give all the time. And I give the example of, you know, being at the bedside of a woman who is delivering a baby. Those are areas that will need nursing presence.

[00:23:42] And so, you know, when nurses get nervous about what does this mean for my job? You know, I think about all the times that technology has come into health care and we have adapted. Right. When you think about the monitors that we use today, when you think about EHRs, yes, it's been uncomfortable and we've had to navigate, you know, where does the nurse then sit in all of this? But that's a conversation. Right. It's a conversation that we need to stay engaged in.

[00:24:06] But what we do as nurses, the humanity in those moments, those are things that will always have to remain. But to your point, how do we do more of that? Because I didn't go into nursing to chart. Right. And to do all. It's not why. When I thought about going to nurse school, that was not the first thought. I really did want to be there with patients to be able to make an impact.

[00:24:31] And I, what drew me into nursing was just the amount of time I could spend with the patient. And, you know, the more and more we get away from that, the more moral distress that I think most nurses feel from that experience. And so how that is the problem that I try to solve on a daily basis is how do we bring nurses back into that side? Definitely. Okay, so let's scale this down because I feel like this is doable. Gave you a big billion dollar concept of like, let's fix it for everybody.

[00:24:59] But if I'm going to take responsibility for learning about AI as a nurse, as an individual, is there like an AI for dummies or some kind of introduction that you'd like to point people towards that they could start learning about? Yeah. Yeah. No. And I'll tell you, that's a hard question. And it's unfortunate that's a hard question because a lot of the AI education that exists today is geared more toward engineers. It's geared more toward even physicians.

[00:25:26] And so it's why I'm starting to develop content alongside universities like Chamberlain and Walden, right? Like we're in the midst of developing a whole series of micro-education courses that nurses can take to learn more about this that's written in the language that would be understandable for a nurse. But what I'd also recommend to nurses is make sure you're attending your conferences. Make sure that you're getting engaged with your professional associations because all of those spaces are trying to talk to nurses about AI. Like I frequently get asked to speak in those spaces.

[00:25:56] It's a great place to start. And then, you know, there's also just a lot of articles out there today, even if they're not, you know, evidenced, you know, like those research articles, right? Like I try to really acclimate myself across the board. I'm listening to podcasts. I am trying to read articles even in mainstream media just to kind of see what the climate is today, you know, and what I need to be thinking about as a nurse in the space, what I need to be doing to educate myself.

[00:26:26] Because the question that I get asked a lot is they're like, how did you learn all about AI to become the CNO of a healthcare tech company? And I was like, honestly, I was hired for my clinical expertise. You know, I wasn't hired because I was the expert in AI. But, you know, I am constantly learning about this. I'm talking, I mean, we have a team of engineers and researchers who are just fantastic and have taught me so much. But I do a lot of like searching just for articles and I get a lot of engagement with professional associations to get a lot of that content.

[00:26:56] Yeah, I know the Kentucky Nurses Association, I think they have like an on-demand class about AI for nurses by one of our members and probably the ANA probably does too. Yeah, Texas Nurses Association, we had a lecture on it and that's recorded. So there are ways to. So that is, it's on the TNA website. Yes, yes. Okay. And then is there a podcast you would recommend like about AI in healthcare or in a conversational way that's a good introductory level for people? What do you think? Yeah.

[00:27:25] So, you know, that's a difficult one. So Anderson Horwitz, they have a podcast called A16Z and Julie Yu is one of their, she's kind of over their healthcare aspect of things. And she actually works with us closely as one of our board members, but she does a fantastic podcast on implementing technology in healthcare. And, you know, I told her a couple of weeks ago, I said, you know, I have actually learned so much as a clinician about from your podcast.

[00:27:52] And so that's one that I recommend because she knows how to explain it in a way that's very easy to understand and is very engaging. And so she does a lot of interviews with clinicians and healthcare tech startups. And so it's a great way to know and kind of get your feet wet on what's out there in the world and the different companies that are trying to solve problems in the space. Okay. Well, definitely. I would love to put a link to that in the show notes as well. Can you say the name of it again? Yeah.

[00:28:20] So A16Z and it's, again, has a whole kind of realm of podcasts. They have a healthcare one, which is the one that I'm talking about. Okay, like a subgroup? Yeah. Yeah. Oh, okay. Very cool. And then I know you can listen on the Health Podcast Network as we have like a whole series of episodes filmed at Health, which was the HLTH conference in Vegas last year. Where are you and now? Right. Yes. And then I just got back from Vive.

[00:28:46] I didn't get to stay the whole time, but Vive is another AI healthcare tech conference. And so our Health Podcast Network members are interviewing tons of people from different companies, learning what they're bringing and offering in AI and hopefully asking some hard-hitting questions. Yeah, it does. Yeah. Let's dive into the ethics of AI or something. But right.

[00:29:10] So if you, if this is a topic, you're listening to this and you want to know more, check out these different podcasts we're talking about and the series around health and Vive conferences, because that really does consolidate it from a lot of different angles too. And then I'm going to share links for Dr. Amy McCarthy's LinkedIn and things in the show notes. So be sure to follow her. Thank you so much for being with me today. Oh my gosh. Thank you so much for the opportunity, Rosa.

[00:29:37] So it's always wonderful to speak with another nurse and to be able to dive into this topic because I think there's a lot of possibilities with it. And I think it's something that nurses need to know about. So thanks for, thanks for the time. Yeah, definitely. So if you've enjoyed this episode of the Nurse Rosa's Insights podcast, please follow on whatever platform you're listening or if you're watching on YouTube.

[00:29:58] And I would love it if you would leave a comment and let me know if you learned something or if you know someone who has a billion dollar idea that needs to see the light of day, then put that in the comment. Get me in touch with them. All of that contact information will be in the show notes and I will see you in the next episode.