IHI Forum: The 'extractive' healthcare system and clinicians' need to reclaim lost purpose

Editor's Note: This story was corrected to reflect that IHI president emeritus and senior fellow Don Berwick does not serve on the National Academy of Medicine committee focused on AI.

Finding purpose during difficult times is a key concern for Kedar Mate, M.D., president and CEO of the Institute for Healthcare Improvement (IHI).

The organization is a nonprofit focused on better outcomes in healthcare and a recent winner of the inaugural Fierce 50.  

In his keynote speech at the organization's 35th IHI Forum, which formally kicked off Tuesday, Mate noted that the pandemic has forced many to confront and reconsider what their purpose is. Particularly for healthcare professionals, he added, the line between purpose at work and in life is blurred. 

“Work remains an incredibly important source of how we think about our sense of purpose,” he said. “Moral injury at work can become real injury at home.” 

Over the past two decades, the industry has systematically separated Mate, and countless others, from his purpose, he said: “In my clinical life, I feel my sense of purpose challenged on a regular basis.” 

“Our health care system has become extractive—not giving but squeezing as much as it can out of every clinical exchange and interaction,” he added. 

He encouraged clinicians, quality leaders, administrators, safety professionals and med students to “take back our system.” He spoke about the needed integration of safety, equity and experience. When they function separately in silos, Mate said, it suboptimizes them all. 

Time and time again, Mate highlighted, large-scale disasters have shown the human side of every person and their ability to come together in love and empathy. From a disaster like COVID, health professionals can find purpose, meaning and—through that—joy, he said.

“How might we build a health and care environment that trusts us, patients and clinicians, and optimizes for our original and intended purpose?” he questioned. “Over the years, IHI has had the privilege of working with many organizations that have taken steps towards this future, and this is the new frontier in quality.”

AI, decarbonization, health equity in IHI's spotlight

This year, the IHI Forum is seeing more than 3,000 attendees in-person and virtually,  representing 52 countries. There are more than 180 learning sessions led by 400 presenters on subjects like health equity, patient and workforce safety, improvement science and building improvement capability. 

One standout theme at the conference and the current work of IHI is artificial intelligence, Mate told reporters at a media session on Monday. Specifically, the organization and those who engage with it are focused on how AI tools might impact patient safety, and how AI can improve the patient experience. 

Mate serves on a committee led by the National Academy of Medicine called the Artificial Intelligence Code of Conduct. Its focus is to create a framework for validation, monitoring and continuous improvement for the use of AI in the field. 

In the media session, Mate cautioned against becoming over-reliant on AI in clinical settings, calling “skill atrophy” a serious concern. He was more optimistic about AI as a tool to improve patient or provider experience, like scribes.

Another area of focus is decarbonization, per Mate. The topic came on the heels of a keynote address Monday by environmental activist Erin Brockovich, whose famous investigation of groundwater contamination in California led to the largest toxic tort settlement in American history at that time.

Since January 2023, 14 health systems have worked with IHI to test strategies to lower carbon emissions from clinical care, in particular focusing on single-use consumables in operating rooms, Mate said. 

“It’s very interesting and hopefully will set a bar on where we might go with Scope 3, which up until this time has been very difficult to tackle for healthcare organizations,” Mate told reporters the day before his keynote. “So we’re starting a way into that conversation.”

Yet another theme across IHI is health equity. The Rise to Health Coalition launched a year ago at the 2022 IHI Forum. The collaborative consists of nine founding collaborators including the American Medical Association, nonprofit Race Forward and others. They aim to recruit providers, payers and life sciences stakeholders to take specific actions on equity through shared solutions.

About 1,600 organizations have joined, Mate said, and about 500 are actively engaged in specific activities.