The U.S. faces a critical shortage of primary care physicians, and the labor crunch is projected to get worse.
There is a projected shortage of 68,020 primary care physicians by 2036, which will be particularly acute in nonmetro areas, according to data from the Health Resources and Services Administration.
And this shortage is contributing to longer wait times for patients to get care. A September Axios/Ipsos poll found that 1 in 5 patients waits more than two months to see a doctor. The average wait time in major metropolitan areas is 26 days.
"The crisis is here. This is not in the future," said Deepthi Bathina, founder and CEO of startup RhythmX AI, a company focused on building generative and predictive AI-powered copilots for physicians to help surface next-best clinical actions and tailor treatments to patients.
Primary care physicians also are under stress from growing administrative burdens and time-consuming paperwork done through electronic health record systems. But, there are other burdens as well, said Bathina.
"There's the moral burden about making the decisions: 'Is this right for the patient? Will the payer pay it?' You have to think through all these things, not just be a doctor. And the third burden is a cognitive burden, which is hundreds of chronic conditions and acute conditions everywhere. The guidelines are changing every day. The primary care clinician is now expected to be experts on the guidelines along with all the financial aspects of care, but you only have 20 to 30 minutes with a patient," Bathina, a former chief clinical product officer at Humana, told Fierce Healthcare in an interview.
RhythmX AI, part of investment firm Symphony AI Group (SAIGroup), calls itself a generative-AI-native precision care company that launched a year ago with a focus on modernizing primary care decision-making with AI-powered information.
The company delivers to doctors advanced gen AI capabilities and predictive AI algorithms based on extensive longitudinal data. The technology offers patient-specific prescriptive actions and recommendations doctors can drill into using AI-native copilots, according to the company. The platform works in concert with existing healthcare systems. The data and rationale behind AI-enabled recommendations are explained, summarized and presented in a single workflow.
"We deliver an enterprise platform to ensure the right type of care to the right patient through the right clinician at the right time," Bathina said.
The company is working with New Mexico-based Presbyterian Healthcare Services to pilot its gen AI platform for primary care clinicians. The pilot project will go live in December at several of the health system's primary care clinics.
Presbyterian Healthcare Services is a not-for-profit healthcare system with nine hospitals, a statewide health plan and a growing multispecialty medical group. The system employs 1,600 providers and nearly 4,700 nurses. Its health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid and commercial health plans.
Lori Walker, chief medical information officer at Presbyterian Healthcare Services and a certified nurse practitioner, sees the potential for AI to improve patient access and quality of care while also bringing back the joy of practicing medicine for PCPs.
"As I've gone out and talked with a lot of our primary care physicians and advanced practice clinicians, they truly still love medicine and they truly enjoy their patients. It's just come down to so much of this cognitive burden and then the time constraints and the complexities of our patients," Walker said in an interview. "We have patients that are driving maybe an hour to see their primary care provider, as we're a very rural state. We have an aging population. They're not coming in with one or two problems, for the most part, they're coming in with maybe five, six or seven problems, and you've got a specific time slot to tackle all that."
"You have to take the time to go through all the areas of the chart, to look at their hypertension, look at their diabetes, look at their hyperlipidemia, and then look at their social needs and all their medications. And am I prescribing them something that is on their formulary? Because if I don't, they're just going to drive to the pharmacy and pay a lot of money, or they're going to refuse it and not take it at all, and there's our adherence issues. It all can cause this perfect storm," Walker noted.
"My hope is that by utilizing this kind of AI, we really can bring all of this information up to the forefront and present the most relevant data to the provider to provide good patient care. So, when our providers get in front of those patients with that 30 minutes, they have all the information they need to make good clinical decisions based on what's being presented and provide good quality care, but also still maintaining that relationship that they have with the patient."
Shaping AI technology as an early partner
As an integrated health system, Presbyterian Healthcare Services is focused on improving patient care and clinicians' workload while also supporting more efficient administrative work on the health plan side and meeting quality measures, Walker noted.
Working with RhythmX AI, the health system aims to use its predictive and generative AI platform to support clinicians, reducing administrative and cognitive burden, as well as improving the patient and member experience, Walker noted.
Walker had been working with the health system's IT team to build a clinical intelligence platform internally to support primary care physicians.
"As a clinician, I understand the hunting and pecking, the gathering out of all the different information, the chart review that goes into it. I have been working with our IT team for probably two to three years and that was just for one chronic condition, for diabetes," she said. "When Deepthi [Bathina] showed me what RhythmX AI does, I was like, 'Oh my gosh, this is what I've been trying to solve for in the last two to three years, but it solves more than one condition."
There is a growing list of companies using gen AI to tackle healthcare administrative work and documentation, including Nuance, which is owned by Microsoft, Abridge, Suki, Nabla and DeepScribe. But, Bathina said RhythmX AI is distinctive as it is "more upstream and proactive than a typical documentation player."
The platform, which pulls in EHR and payer data, offers advanced patient risk stratification and prediction to help identify patients at risk and surfaces relevant information to help clinicians identify the right next steps. The technology also provides insights and predictions for the best care and intervention plans and offers recommendations for holistic care, including labs, imaging, social care, follow-ups and medications, according to the company.
RhythmX AI's patient orchestration also routes patients to the best clinician, whether a PCP, advanced practice provider or specialist, with the relevant prep and diagnostics, the company said.
Presbyterian and RhythmX AI worked together to develop agreed-upon conditions and guidelines to build the AI-powered care insights and interventions. "We will track how many of our recommendations are actually being accepted by clinicians and our goal is to keep on increasing it, because that's where we prove our value," Bathina said. The platform also surfaces recommendations to meet specific quality measures as identified by the health system, she noted.
She stressed that the collaboration with Presbyterian is important as the company continues to build out the product road map to address providers' biggest pain points. RhythmX AI team members also visit Presbyterian clinics in person to observe how physicians are interacting with patients and using technology, which informs the company's tech development, she noted.
Those observation sessions help build trust with the providers involved in the pilot, Walker noted.
Further, IT teams at both organizations work together to ensure the technology is integrated into providers' workflow.
"We are truly developing with this vendor and with this AI. I feel that Deepthi and her team are truly listening to us and what we are struggling with," Walker said.
For RhythmX AI, it was critical to find the right foundational health system partners. "The early foundational partners could make or break the entire company," Bathina said, noting that the company wants to work with innovative health systems.
RhythmX AI's platform will surface clinical interventions initially but will eventually expand to flag social needs and mental health interventions. For Presbyterian, AI-based technology that can help expand access to care, improve specialist referrals and address social needs would be immensely beneficial, Walker noted.
"We have a lot of social needs within our state. When we talk about patients coming in and we're going to address their medical conditions, we also have to address their social conditions at that time, and for the majority of our patient population, that's usually fairly large. Surfacing those social determinants of health is huge. If our patients don't have transportation, how can we expect them to get to these appointments? RhythmX is a way to surface those social needs and then get them to the appropriate community health workers that we have embedded in our organization," she said.
Walker added that Presbyterian has taken a "thoughtful, mindful" approach to deploying AI.
"AI is moving very quickly. We are getting contacted frequently by vendors on partnering. We're doing our due diligence and our review in piloting a small number of AI tools, RhythmX being one of those and we put a lot of thought into this partnership," Walker said. "When we are considering which AI tools we want to go with and which partners we want to go with, I think we're really trying to take a step back and talk to our operational leaders and talk to our physicians and advanced practice clinicians about, 'What is our problem? What problem are we trying to solve, versus just going out to our vendors and just trying to find a solution."
RhythmX AI expanding partnerships with health systems
In February, RhythmX AI unveiled a strategic partnership with Virginia-based Sentara Health to deploy its gen-AI-based copilot for physicians.
The company is now targeting expansion to 15 health systems nationally beyond Presbyterian in 2025, Bathina said.
RhythmX, which launched with $50 million, is able to tap into SAIGroup's capital and expertise. It leverages SAIGroup assets, including the advanced Eureka AI platform and longitudinal data related to 300 million patients, more than 4.4 billion total annual claims, and more than 1.8 million healthcare professionals at more than 300,000 facilities. "We're not your typical startup. With the kind of access to capital and data and the leadership profiles, it's unbelievably unique," Bathina said.
The company has been building out its leadership team and expert advisers. Nathan Gnanasambandam, Ph.D., a former UnitedHealth and Highpointe Solutions executive, joined as vice president of AI. Joe Petro, corporate vice president of Microsoft Health & Life Sciences Solutions and Platforms, joined RhythmX AI’s advisory board.
SAIGroup founder and CEO Romesh Wadhwani, Ph.D., a billionaire Silicon Valley technology leader, has committed $1 billion of his personal fortune to advance predictive and generative AI.
SAIGroup invests in enterprise AI software companies. It's portfolio includes SymphonyAI, which is used in retail, financial services and other industries, as well as clinical AI and real world data company ConcertAI. In July, the investment firm acquired digital patient engagement company Get Well. The company developed solutions supporting more than 10 million annual patient interactions at over 1,000 healthcare organizations, and it works with a growing list of enterprise health systems.
At the time of the acquisition, SAIGroup said it plans to "supercharge" Get Well's patient engagement solutions with predictive and gen AI technology.
RhythmX AI has started working with a select group of the more than 1,000 hospitals where Get Well’s patient engagement platform is deployed.