NewYork-Presbyterian is a nonprofit academic health system based in New York, with hospitals, ambulatory sites, and care services across the metropolitan area. It works in close collaboration with two renowned medical schools, Columbia University Vagelos College of Physicians and Surgeons and Weill Cornell Medicine, combining patient care, medical education, and research.
What are academic health systems being asked to do today that they were not being asked to do a decade ago?
Academic health systems are being asked to do more and more. They have to continue providing care for their communities while remaining on the front edge of innovation, discovery, and new models of care. The need for that work is still there, as it should be, but it is becoming harder to put it all together.
What is different now is the pressure on the care model in the U.S. healthcare system. Financial pressures, increasing costs, and labor issues all make it more challenging for academic health systems to keep leading innovation while meeting the demands placed on them.
What does building the academic medical center of the future mean in practice, and how do you make sure discoveries reach patients?
One of NewYork-Presbyterian’s great distinguishing factors is having two phenomenal partners: Columbia Doctors and Weill Cornell Medicine. Innovating the future of care means staying current, improving the experience for patients and the workforce, and looking at how to reduce the burden of disease.
The proximity between research and clinical care matters. The clinical practice is connected with two medical schools, supported by engineering, computer science, and the universities themselves. That allows discovery to move through the NewYork-Presbyterian healthcare system and get to the bedside more quickly. Physician leadership is critical, and the patient has to remain at the center from the formation of any innovation.
Where is AI making the biggest practical difference today, and what does it take for clinicians to trust it?
The biggest practical difference so far is in operations: revenue cycle, business practices, and tools such as ambient listening that help providers. One clinical example is EchoNext, which uses routine EKGs — millions of which are performed — to identify concern for structural heart disease. NewYork-Presbyterian has already done the first heart transplant diagnosed through AI, as well as some of the first heart valve replacements in patients identified through AI.
That is still in its infancy, and it is tremendously exciting, but trust is central. Clinicians adopt tools when they see that they are better for patient care. The challenges are governance, cost, and making sure AI is used responsibly. AI can be a teammate, digitally enabling the workforce, but AI will not be the care model.
How is the shift toward ambulatory care, specialized outpatient facilities, and hospital-at-home changing the role of the hospital?
Innovation in healthcare is like innovation in any other industry: it allows more treatment to be done in better settings for patients, including outpatient settings and the home. NewYork-Presbyterian is running a Hospital at Home program and has long invested in outpatient locations such as the David H. Koch Center in Manhattan, facilities in Westchester such as NewYork-Presbyterian The One, and the Center for Community Health (CCH) at NewYork-Presbyterian Brooklyn Methodist Hospital.
The next step is not just building more facilities, but using technology to reach patients beyond them. The system will continue to put centers of care in place, but also think about how to leapfrog past facilities and care for patients where they are.
How do you respond to criticism of NewYork-Presbyterian’s rural referral designation, and what does the debate over hospital costs often miss?
NewYork-Presbyterian does not claim to be a rural hospital; it qualifies as a rural referral center under federal guidelines (Centers for Medicare and Medicaid Services). The previous year, it saw about 8,000 patients referred from rural America. For those patients, families, and physicians facing rare and hard problems, having a place to turn is meaningful.
The cost debate often misses what it takes to run a major health system. NewYork-Presbyterian has 45,000 employees and affiliated physicians, 12 million square feet of facilities, and six million square feet that are more than 50 years old. Pharmacy costs rose 25% in the previous year, and caring for Medicaid patients created a billion-dollar shortfall. Patients are also about 5% sicker than before, which means hospitals are treating higher-complexity cases.
What solutions can help address affordability and inefficiency without weakening access or quality?
No one group can solve affordability alone. It will take pharmaceutical companies, insurers, hospitals, government, and patient advocates. But the focus on affordability cannot come at the expense of access or quality. AI can help increase efficiency, particularly in corporate functions, financial operations, and parts of the care model, but it is not a silver bullet.
There are also opportunities to reduce how often patients need to come into the hospital. A day in the hospital carries costs beyond the bill: time off work, travel, parking, and disruption. If more care can be done at home, physicians can focus on the most meaningful aspects of disease. Quality is also part of the cost equation: failed surgeries, readmissions, more medications, and recovery time all increase the total cost of care.
Beyond scale, technology, and research, what defines a truly successful hospital today?
A successful hospital delivers outstanding clinical care with empathy. The core thing that we do in a healthcare system is we deliver empathy. The word hospitality has hospital in it for a reason: quality matters, but so do compassion, experience, and the way care is delivered. As AI and information become more democratized, the differentiator will be the human experience of care.
That also applies to the workforce. Team members need meaningful time to express empathy to patients and receive empathy from them. Culture, values, and engagement are not soft issues; they drive efficiency and better care. People want meaning and purpose, and opportunities to learn and grow. My role as a leader is to make sure 45,000 people can be their best, because they will do extraordinary things for patients.
