By Alexis Kayser
Healthcare Editor
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Dr. Tom Mihaljevic has been in medicine too long to believe that AI is a cure-all.
The Cleveland Clinic president and CEO is at the forefront of technological innovation in health care, guiding the organization through partnerships with AI giants: Palantir, IBM, Oracle.
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But health systems—even those that stand on the cutting edge—will have to work hard to make AI work for them, Mihaljevic indicated during his April 27 conversation with Suraj Srinivasan, professor at Harvard Business School, as part of Newsweek’s “AI Agenda” webinar series.
“Many people are waiting for AI solutions like some kind of magical dust that will be sprinkled in their organization, that it will solve all problems that they may currently be having,” Mihaljevic said. “We [at Cleveland Clinic] do not think that is necessarily the answer. I think a lot of pre-work needs to be put in place in order to really harvest the potential of artificial intelligence in health care.”
AI is not the single answer to longstanding questions about the health care system’s sustainability, according to Mihaljevic. Rather, he sees AI’s automation and augmentation capabilities as boosters that can accelerate the redesign of a failing care model. The tech could support industry leaders and clinicians as they work to make health care more sustainable at scale.
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That’s the “biggest problem in health care,” Mihaljevic told the audience: “We still have to find a model that will allow us to offer exceptionally good care in a timely manner to all of those in need, but also at affordable prices. That system currently does not exist.”
“[Even] with a lot of efforts to improve the existing models of care delivery, we are still being plagued by the same problems,” he continued, noting that few can access “exceptional care.” Even that lucky subsect struggles to find timely, affordable medical services.
“We do believe that AI has this transformative opportunity to help us solve this biggest problem in health care today,” Mihaljevic said.
The key word there is “help.” Over the last five years, Cleveland Clinic has undergone a “deep” restructuring to homogenize clinical service lines, digital infrastructure and data sharing across all of its 370 service sites, spanning three continents.
“We have a new operating model when we really function as one unit...the greater degree of standardization and uniformity lends itself to a much more impactful, quicker and more effective rollout of these new technologies,” Mihaljevic said.
The Clinic also recruited a new digital leadership team, sourcing computational science and AI expertise from outside the health care industry. Its chief digital, AI and data officers have no prior health care experience—but they do have connections in Silicon Valley.
This was intentional. Mihaljevic said that Craig Mundie, former chief research and strategy officer at Microsoft, gave him one of the best pieces of advice as he considered the talent pool.
“[Mundie] told me that when you start the search process, understand that if you’re looking for somebody with a health care background, that should be a disqualifier for the position,” he said, “meaning look really, really carefully for people who have an in-depth understanding of computational space and science.”
However, Silicon Valley talent isn’t cheap. Few health systems have the resources to hire such a qualified suite.
Srinivasan, the host of the “AI Agenda” series, raised that question to Mihaljevic.
“We have this concern about the AI haves versus the AI have-nots,” Srinivasan asked. “I was curious how that might play out in health care.”
The industry is aware of the potential divide and concerned about its implications on equitable care, according to Mihaljevic. The U.S. Department of Health and Human Services administration is pushing for broader AI adoption and data-sharing infrastructure, which the Cleveland Clinic CEO sees as directionally right. But for that to matter in health care, large, integrated systems need to collaborate far more closely, he said.
“The broader topic here is what the future of health care looks like and to which extent an extreme fragmentation of health care delivery in the United States is conducive to a transformational effect of artificial intelligence in U.S. health care,” Mihaljevic said. “I do not believe that current landscape—when we have more than 5.5 thousand hospitals in the United States, many of them very small, under-capitalized, under resourced—is the best ground to maximize on the use of AI for the betterment of the health of the Americans.”
Most hospitals lack strong cybersecurity capabilities, he added, and a fragmented digital landscape makes health care an increasingly attractive target for cyberattacks—particularly as more advanced AI tools lower the barrier for bad actors.
Even if hospitals can’t develop these capabilities independently, Mihaljevic believes they could still benefit from them. He views Cleveland Clinic’s AI efforts as a "proof-of-concept" that can eventually be scaled to all of those in need, at affordable prices.
“Artificial intelligence is geography agnostic, so it can be deployed in urban and in rural settings,” he said. “And this is the attractiveness of it. I think it leads, essentially, to democratizing exceptional care.”
Throughout the conversation, Mihaljevic emphasized that health care “should not be an exclusive product.” He also acknowledged the reality: right now, it is.
“We wake up every single day with a healthy understanding that change is necessary,” he said.
Near the end of the virtual event, Mihaljevic discussed AI’s potential in primary care delivery. The specialty is currently prone to lengthy delays, subpar quality and workforce shortages.
The Cleveland Clinic chief foresees a time when “most primary care will be delivered through AI.” But he cautioned that it won’t be a quick or easy fix.
“We’re not necessarily looking to attach AI onto an existing model of primary care delivery, but to do exactly the inverse,” Mihaljevic said, “to reconstruct or recreate the ecosystem for primary care delivery by putting an AI not on the surface of the current system, but in the center of the future system.”
Mihaljevic made it clear that if AI is to reshape health care, it won’t be by fixing the system we have—but by forcing the industry to build one that works.
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