02-05-2025
Using AI for good: Advancing health equity and saving lives
For all its power to transform administration and innovation, AI can revolutionize equity and access to care and become a force for good in the medical field. At Intersect 2025, San Francisco General Hospital Foundation (SFGHF) CEO Kim Meredith sat down with Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) Cardiologist Dr. Lucas Zier for the breakout panel, 'Using AI for Good: Advancing Health Equity and Saving Lives.'
Sponsored by the San Francisco General Hospital Foundation, this presentation discussed the incredible results AI has already created here in San Francisco, including the reduction of heart failure readmission rates by 13 percent and mortality rates by six percent. The panels also discussed the potential of public-private partnerships and ways to deal with constricted federal funding.
Through the Zuckerberg Patient Care and Quality Improvement Fund (ZPCQI), SFGHF has invested in Zier's research as co-founder and director of the PROSPECT Lab at ZSFG (Pioneering Research and Organizational Solutions to Promote Equitable Care through Technology) — the digital innovation team at the city's public hospital. 'Our foundation represents the potential of public-private partnership, bringing private support for this public institution. We are investing in new technologies, especially AI,' Meredith says.
The patients at ZSFG are extremely diverse, making equity of access to treatment a priority. According to Meredith, 'About 40 percent of our patients are from the LatinX community, 20 percent from the Asian American community, and 15 percent are from the African American community. And more than 90 percent of all our patients benefit from some sort of public assistance.'
Zier serves as Director of Cardiovascular Quality and Outcomes at ZSFG and an Associate Professor at UCSF. His work with the PROSPECT Lab began in 2017, 'not because of some major technological breakthrough, but to solve a problem in our system. We had major challenges with heart failure care, particularly with elevated readmission rates. Inequities led to elevated mortality rates,' Zier explains. 'These issues put us at risk of losing $1.2 million per year of public funding.'
The PROSPECT Lab initially developed AI pilots which were successful, but not scalable across ZSFG. 'We built an integrated AI model to identify our highest-risk heart failure patients with basic machine learning,' Zier says. By tailoring risk prediction to suggest specific actions, the PROSPECT Lab team reduced readmission rates by 13 percent and mortality rates by 6 percent.
The new AI-driven model also eliminated significant equity gaps in outcomes for African American heart failure patients. 'By meeting the readmission metrics and retaining $1.2 million a year in public funding, we've saved the health system almost $8 million in total,' Zier says.
This success has made Zier a national leader in AI and medical equity. ZSFG recently hosted leaders from 15 public hospitals across the US, including Parkland Hospital in Dallas and Grady Hospital in Atlanta, to share this new approach to saving lives.
Describing what makes the Prospect Lab so unique, Zier says, 'We had a clear problem we were trying to solve, and a clear plan for improving ROI. My lab is very bullish about machine learning and AI, though we understand that we can't just flag who is high risk but must link those patients to specific workflows and plans. For example, we identified that our patients who had heart failure and were using methamphetamines were at considerable risk. So, we developed the Heart Plus clinic staffed with both heart failure and addiction medicine specialists.'
The PROSPECT Lab owes much of its success to a combination of public and private funding, which Meredith endorses as a key component to successfully integrating innovation and healthcare. 'When I think of scaling, my first instinct is to start with private philanthropy,' she says, 'then work with public institutions and government to expand across the country.'
Even with interest in AI at an all-time high, the current political climate poses challenges to any healthcare research, especially regarding equity and inclusion. 'Funding for health equity research is at risk right now, so other sources, including philanthropy, can step in,' says Zier. 'Health systems should not be deploying large-scale tools without a pilot to demonstrate efficacy. By starting small and expanding, researchers and providers can build the organizations they need.'
The PROSPECT Lab is a case study for how AI and machine learning, when applied strategically, can make an enormous difference for healthcare providers and patients alike, even when equity is out of favor with regulators. For their visionary work, ZSFG and the PROSPECT Lab received the Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity in 2024.
'This project took ZSFG from the worst performing safety health system in California to one of the best, if not the very best,' says Zier.
