In March 2025, Healthcare Innovation interviewed David Carmouche, M.D., govt vp/chief medical and business officer at value-based care firm Lumeris, about an AI-powered major care answer named “Tom” in honor of Lumeris co-founder Tom Doerr, M.D.
Now Lumeris, which companions with well being methods 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 mentioned this may allow it to raised assist HMH physicians and care groups in coordinating preventive, longitudinal take care of 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 the Facilities for Medicare & Medicaid Providers (CMS) Medicare Shared Financial savings Program (MSSP).
The partnership, which at the moment focuses on Business and Medicare Benefit packages throughout Hackensack Meridian Well being Companions, HMH’s clinically built-in community (CIN) of major care suppliers, will now prolong to Conventional Medicare beneficiaries by the HMH Accountable Care Group (ACO). Lumeris mentioned it might construct on individuals, processes, analytics, and expertise 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 major care-as-a-service answer. Carmouche mentioned that description signifies that there are many companies that may be delivered in major care, a few of that are delivered right this moment inefficiently, and that could possibly be executed extra effectively with automation. “There are some companies that ought to occur however that simply do not occur as a result of the care staff doesn’t have the time or capability to do this. Main care as a service is utilizing a knowledge basis to energy a number of AI brokers that may tackle these companies and try this in an organized method primarily based on the information of what a person affected person wants subsequent on their well being journey,” he added.
He defined that if in case you have this information infrastructure that’s inclusive of the digital well being file, doubtlessly claims, information units, client information, social determinants of well being insights, and many others., “we are able to decide, in lots of instances, the subsequent smartest thing that ought to occur for somebody to enhance their well being, and in some instances, that may contain an automatic outreach to a affected person. It could be academic, it might be a reminder, it might be a nudge, it might be a immediate. We’re not taking people out of the loop. People are nonetheless required to make diagnoses. We could recommend info or summarize info for a doctor that may inform a analysis, however finally, a clinician is doing that. A clinician nonetheless is required to prescribe a medicine, however there’s rather a lot that occurs round that that we expect AI might help with as a 365 24/7 always-on associate for a major care physician.”
Clinically built-in networks often have many alternative EHR methods. Carmouche was requested if Tom needs to be custom-integrated into the EHRs of the supplier methods. He mentioned 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 many others., 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 need not get built-in into the EHR. There could possibly be duties and alerts to different care staff members that most likely might come into a distinct software within the workplace. However the concept that Tom could possibly be interacting with sufferers outdoors of the view of the physician is a brand new dynamic, proper? It occurs right this moment with people— for example, a care supervisor would possibly 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’ll should floor to the clinician summaries of what Tom has executed. I feel they are going to wish to see that. Whether or not that is deeply embedded within the EHR someplace, or whether or not it is a desktop software that sort of slides over into view and simply has a quick abstract, I feel every group may have a distinct view of it. We’re ready, the place obligatory, 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 workplaces in St. Louis and Boston and generated $3 billion in revenues in 2024.
