UTMB core innovation team codevelopment initiatives improve patient care and outcomes

Two patients are waiting for their colonoscopy appointments to be scheduled. One is a 45-year-old who is following routine screening guidelines. The other isn't feeling well and has abdominal pain, atypical bleeding, and anxiety about the situation.

At The University of Texas Medical Branch (UTMB Health), an algorithm distinguishes between levels of urgency in these two medical cases and prioritizes the symptomatic patient for an appointment.

Similar technology is used to triage patients awaiting appointments in high-demand specialties, including nephrology, endocrinology, infectious disease, and rheumatology.

"We get patients out of the work queue and get them appointments to get them into the clinic quicker," said Raul Perez, associate director of information services. "That's the whole idea."

Leveraging AI to benefit patients

The UTMB Information Technology Services (ITS) core innovation team is leveraging artificial intelligence to improve patient access, streamline care coordination, and support clinicians through custom codevelopment initiatives. Without ever stepping into the clinical environment, the team is helping to save lives by creating tools to optimize healthcare in a multitude of ways.

It's part of a philosophy often mentioned as the team's "North Star" by Dr. Salim Hayek, chair of internal medicine and vice president and chief transformation officer at UTMB: "Right patient. Right provider. Right level of care. Right time. All the time."

The core team evaluates project ideas brought to them by co-developers, vendors, and internal stakeholders and decides which initiatives to pursue.

"Potential partners come in with this idea - this ball of clay," said Perez. "We help them develop it into something more meaningful. These are practical applications of AI that are already making a difference for patients and staff. By using advanced analytics and automation, we're reducing delays and allowing our care teams to spend more time focused on patients."

Innovating in a dedicated sandbox

To move selected initiatives forward, the core team defines the required workflows, integration strategies, and technical architecture. Team members work in a dedicated innovation sandbox - a secure, isolated development environment designed specifically for testing, codevelopment, and exploration of new digital tools without risk to live clinical systems.

Unlike traditional test environments, the sandbox is intentionally separated from production workflows, allowing teams to safely evaluate ideas before determining whether they are ready to advance.

"This environment gives us the freedom to innovate responsibly," Perez said. "We make deliberate decisions about whether a project is purely exploratory or intended to move toward clinical use, and that governance is critical when you're working with emerging technologies like AI."

Through this model, UTMB has been recognized as an early adopter within The University of Texas System for establishing a formalized innovation environment dedicated to enterprise and clinical technology development. Development teams from other UT institutions have been consulting UTMB ITS as they establish similar programs.

This initiative has also provided this group of developers, along with UTMB ITS Project Manager Lauren Gann, with a renewed sense of passion, purpose, and excitement for the work they do.

"We are innovating and doing things we have never done before," Gann said. "That's exciting."

For example, UTMB is one of the first institutions nationally to deploy an enterprise-wide, HIPPA-compliant generative AI chat application. Every UTMB employee now has safe, secure access to this resource that could be used by a medical team working on a complex diagnosis or an innovator sourcing supplies for a medical device prototype.

Codevelopment requires flexibility

Joshua Russow, an electronic health record clinical solutions analyst at UTMB, enjoys the unique challenges the team gets to tackle in the innovation sandbox.

"We are given an objective, and we have incredible freedom regarding how we implement solutions," Russow said. "This allows us to move very quickly and try new things, but it also requires us to seek frequent feedback so that we properly account for the needs of stakeholders, affected teams, patients, and users."

Because the work is constantly evolving, developers must stay adaptable.

"The stakeholders and objectives are often not clearly defined, and the direction of the project changes as we do the work and figure out what is even possible," Russow said. "We need to be quick and detailed to develop proof-of-concept solutions, throw out what doesn't work, and then carefully build out the functionality so that it feels seamless to end users."

Another key to the success of the core team is finding the right codevelopment partners. These can range from technology startups to other UTMB departments to longtime vendors.

"I really enjoyed creating our new e-consult framework," Russow said.

E-consult is a messaging platform that allows a primary care provider to request specialist input on a medical case, without the patient having to go to a separate appointment.

"This project integrated our existing referral workflows with a novel e-consult framework so that low acuity referrals can be handled in a more efficient manner," Russow said. "Creating this workflow with the standard Epic tools forced creativity and required a great deal of technical knowledge. I am very thankful that we have a consultant, Sean Brown, on this project. We bounced ideas off each other and coordinated complex build, allowing us to complete the work much more efficiently and completely than if we had developed this alone."

Perez said while various developers work on projects that apply to their areas of expertise, Lloan Cortes, an electronic health record clinical solutions analyst, plays a key role on many projects.

"Lloan is very quick in responding to the codevelopers' needs. He's a huge asset on this initiative," Perez said.

While some implementations that perform such tasks as reducing Medicare and Medicaid claim denials may seem like efficiency measures, delays in care are directly related to patient outcomes. Ensuring access to care is an important goal for the core team, Gann said.

A model for other health systems

Beyond the specific innovations the team develops, the process itself is an innovation. Starting in a designated creative sandbox environment gives the team the freedom to test new ideas. The structure helps ensure that any solution considered for broader use is intentionally rebuilt and validated before entering testing and production phases.

The innovation sandbox supports broad experimentation while maintaining a clear path to implementation.

"Having a team that embraces agility and is willing to operate at an uncomfortable pace is the rocket fuel behind our innovation efforts," Perez said. "It enables us to rapidly transform ideas into impactful solutions, accelerate meaningful change, and, in some cases, position us as one of the first healthcare organizations to bring new capabilities to market."

Healthcare has never lacked data; what it lacks is the ability to transform that data into timely, actionable insight, Perez explained.

"AI serves as the bridge between information and impact, helping UTMB make smarter decisions, improve outcomes, and deliver more personalized care. Recognizing this opportunity early, we were among the first healthcare organizations to establish an Epic AI Sandbox designed specifically for collaboration and codevelopment," Perez continued. "By creating a safe environment where clinicians and operational leaders can innovate together, we have accelerated experimentation, reduced barriers to adoption, and increased our ability to rapidly translate ideas into real-world solutions. This foundation allows us to move with greater agility, scale innovation more effectively, and position ourselves at the forefront of AI-driven healthcare transformation."