In March 2025, Healthcare Innovation interviewed David Carmouche, M.D., govt vp/chief medical and industrial officer at value-based care firm Lumeris, about an AI-powered main care resolution named “Tom” in honor of Lumeris co-founder Tom Doerr, M.D.
Now Lumeris, which companions with well being programs and doctor practices on value-based care preparations, has introduced that in an growth of their partnership, 18-hospital Hackensack Meridian Well being (HMH), New Jersey’s largest built-in well being community, will deploy the Tom platform to allow monitoring, efficiency administration, and scalable best-next-action workflows embedded in medical operations. Lumeris stated it will allow it to higher assist HMH physicians and care groups in coordinating preventive, longitudinal look after seniors, whereas decreasing avoidable utilization and administrative burden.
St. Louis-based Lumeris and HMH are increasing their value-based partnership to incorporate Conventional Medicare by means of the Facilities for Medicare & Medicaid Providers (CMS) Medicare Shared Financial savings Program (MSSP).
The partnership, which at present focuses on Business and Medicare Benefit packages throughout Hackensack Meridian Well being Companions, HMH’s clinically built-in community (CIN) of main care suppliers, will now prolong to Conventional Medicare beneficiaries by means of the HMH Accountable Care Group (ACO). Lumeris stated it could construct on individuals, processes, analytics, and know-how already established all through the CIN to operationalize a risk-based MSSP ACO program that helps proactive, physician-led care.
When Lumeris first launched Tom, it was described as an AI-powered main care-as-a-service resolution. Carmouche stated that description signifies that there are many providers that may be delivered in main care, a few of that are delivered right now inefficiently, and that may very well be accomplished extra effectively with automation. “There are some providers that ought to occur however that simply do not occur as a result of the care workforce doesn’t have the time or capability to try this. Major care as a service is utilizing a knowledge basis to energy a number of AI brokers that may tackle these providers and try this in an organized method primarily based on the data of what a person affected person wants subsequent on their well being journey,” he added.
He defined that when you have this knowledge infrastructure that’s inclusive of the digital well being file, probably claims, knowledge units, client knowledge, social determinants of well being insights, and so forth., “we are able to decide, in lots of circumstances, the subsequent neatest thing that ought to occur for somebody to enhance their well being, and in some circumstances, that may contain an automatic outreach to a affected person. It might be instructional, it could be a reminder, it could be a nudge, it could be a immediate. We’re not taking people out of the loop. People are nonetheless required to make diagnoses. We might recommend info or summarize info for a doctor that may inform a prognosis, however in the end, a clinician is doing that. A clinician nonetheless is required to prescribe a drugs, however there’s so much that occurs round that that we expect AI might help with as a 365 24/7 always-on accomplice for a main care physician.”
Clinically built-in networks often have many various EHR programs. Carmouche was requested if Tom needs to be custom-integrated into the EHRs of the supplier programs. He stated there are 119 completely different EHRs Lumeris works with now. “We do not have deep integrations with 119 EHRs, however with the large ones like Epic, and so forth., we do. I imagine that the extra we are able to combine Tom into the EHR workflow, the extra doubtless clinicians are to undertake it. There are components of what Tom will try this needn’t get built-in into the EHR. There may very well be duties and alerts to different care workforce members that in all probability may come into a unique utility within the workplace. However the concept Tom may very well be interacting with sufferers outdoors of the view of the physician is a brand new dynamic, proper? It occurs right now with people— for example, a care supervisor may name a affected person and work together with them, and someplace within the EHR, there could also be a tab the place that’s documented. Early on with AI, to construct belief, I feel we will should floor to the clinician summaries of what Tom has accomplished. I feel they’ll wish to see that. Whether or not that is deeply embedded within the EHR someplace, or whether or not it is a desktop utility that type of slides over into view and simply has a short abstract, I feel every group may have a unique view of it. We’re ready, the place needed, to combine to the diploma that the shopper will need it or demand it.”
Lumeris says it employs 1,200 engineers, healthcare specialists, and clinicians throughout places of work in St. Louis and Boston and generated $3 billion in revenues in 2024.
