MultiCare announced a strategic investment in Layer Health, an AI company out of the Massachusetts Institute of Technology bringing the first comprehensive chart review algorithm to market.
Layer Health is trying to solve one of the hardest clinical reasoning problems in healthcare: how to get the right treatments to the right patients at the right time. Layer’s large language model (LLM) can assess longitudinal patient data scattered across health records to understand the type of care the patient received and the outcome.
David Sontag, Ph.D., CEO of Layer Health and a professor at MIT, said the issue Layer is trying to address is “one of the hardest problems in clinical reasoning.” Sontag founded the company with Divya Gopinath, Luke Murray, Monica Agrawal, Ph.D., and Harvard emergency physician Steven Horng, M.D.
Health systems spend significant money and manpower on manual chart review, usually by a team of nurses. As Sontag explained, these teams of nurses survey a random sample of patient charts for purposes of outcome reporting or submitting patient data to clinical registries.
A clinical registry is a database that collects and analyzes health-related information about patients. Registries can help improve the quality of care for patients and the effectiveness of treatments. Many specialties have clinical registries, but they are hard for health systems to take part in because of how many data have to be extracted from charts.
Clinical registries and chart abstraction are key to understanding what treatments work best for patients and to standardize clinical care, Sontag said. To answer the long list of questions thoroughly, Layer has trained its algorithm to be able to look at a much larger swath of unstructured patient data than other LLMs of its kind.
“It's no longer to get the question of just looking at face value what's written in, you know, one small part of a medical record, but rather being looked holistically at a patient at the same level that a physician would be able to do," Sontag said.
He gave the example of a health system trying to assess whether it followed the clinical guidelines for heart failure. The question becomes complex based on the individual situations of each patient.
“Imagine you're trying to assess the compliance with guidelines for management of heart failure, where you might say patients who have a particular type of heart failure should usually get this type of treatment,” Sontag explained. “Except there are a huge number of caveats … it's those caveats which make everything so hard.”
The issue of chart review, and the pioneering approach of Layer Health, attracted the interest of Washington-based MultiCare Health, a system of 13 hospitals across the Pacific Northwest. Through its venture arm, MultiCare Capital Partners, the system invested in Layer Health.
MultiCare has previously published about the issues of chart review, which fostered mutual interest for Layer. Sontag also said Layer Health and MultiCare share a vision for a future of better patient care.
Jason Parks, chief innovation officer for MultiCare Health System who also serves as managing director of MultiCare Capital Partners, said it invested in Layer because of its proven ability to be innovative and the scale of the issue of chart review, which will be applicable to a large part of the industry.
“We don't necessarily think of ROI from a purely financial perspective,” Parks said. “We actually look at it first and foremost, from a clinical perspective, and the return on investment for the patients in the communities.”