Scripps Weathers the Biggest Healthcare “Storm” in Modern Times

A newspaper empire and an order of Catholic nuns are responsible for the modern-day, San Diego-based Scripps Health, a nonprofit healthcare system with over thirteen thousand employees, five hospitals, nineteen outpatient facilities, and a patient population of five hundred thousand every year. 

Scripps Health was initially proposed by Ellen Browning Scripps in 1917 and formally founded in 1924. Browning, a journalist and philanthropist, and her brother E.W. founded the largest chain of newspapers in the US. The vast wealth she accumulated ($3 billion, adjusted for inflation), she gave away. Along with Scripps Health, Browning helped found the Scripps Institution of Oceanography, Scripps Research Institute, as well as the Scripps National Spelling Bee.

Mercy Hospital, the longest-established hospital in San Diego, would join Scripps Health in 1995. The Sisters of Mercy would eventually raise $200,000 for the hospital which also opened in 1924.

The project was spearheaded by Mother Mary Michael Cummings whose list of accomplishments as leader of her order included a home for the elderly in San Diego, the city’s first training school for nurses, a home for the homeless and orphaned children, and a ranch used to provide dairy and vegetables for hospital patients. Cummings wouldn’t live to see Mercy Hospital completed, however, as she died in 1922.

One hundred years later, Scripps highlighted its efforts piloting an artificial intelligence tool “aimed at streamlining physician-patient communications.” Using large language model AI, the technology crafts a reply to a patient query based on current medication regimen, recent results, and other clinical data.

“This technology is not designed to predict treatments or provide evidence-based decision support. Rather, it serves to make the initial drafting process more efficient, all while upholding stringent security measures that protect patient health information,” Dr. David Wetherhold, chief medical information officer for ambulatory systems at Scripps Health, said in a statement.

“It’s a virtual assistant that tees up messages for clinicians to review, allowing us more time for direct patient care,” he said. “Clinicians remain an irreplaceable part of the communication loop with patients. This AI tool is an assistant, not a substitute.”

The goal of AI integration is to reduce clinician burnout. According to Wetherhold, the volume of patient messages has increased roughly 50 percent since the pandemic, significantly cutting down on time that clinicians would otherwise be spending with their patients.

The program pilot occurred in 2023 and was expected to roll out to other parts of the organization after addressing clinician feedback.

Implementing AI integration is one solution, but more so indicative of a much larger problem in healthcare, according to Scripps. The health system highlighted the “perfect storm” of financial challenges faced by all healthcare organizations at present.

“It sounds bad because it is pretty bad,” Scripps Health President and CEO Chris Van Gorder said in a published story on the health system’s website. “Today healthcare is navigating a financial storm unlike anything it has ever seen. More than half of California’s hospitals ended 2022 with a financial loss and one in five is at risk of closing. We all rely on hospitals and health systems to help others, but now they’re the ones that need some help.”

The post-pandemic recovery isn’t entirely a recovery. Supply shortages that were a hallmark of the early pandemic period have actually gotten worse. Staffing remains incredibly competitive as so many left the hospital positions during the pandemic. And post-pandemic volume rose by 10 percent at Scripps thirty-plus clinics, a great deal of which was patients who delayed nonemergency medical treatment during the pandemic but are now paying a greater price for waiting.

Throw in inflation, insufficient reimbursement, and new mandates, and the challenges are quite clear. The solution is not. There are just too many issues on too many fronts. Those like Joanna Caballero, corporate vice president and revenue cycle professional, are constantly asked to do more with less, but it’s Caballero’s specialty. With over twenty-three years of academic experience, Caballero made inroads before assuming her current title in patient access, clinical coding, revenue cycle management, billing, and liability.