Overview

Sentara Health, an integrated not-for-profit system with 30,000 employees and $11.2 billion in operating revenue, was sitting on more patient data than its clinicians could possibly read. Regard changed what happened to that data at the point of care.

Key results

• Increased CC/MCC capture by 17%, enabling up to a 4X ROI per user
• Consistently improved severity of illness (SOI) and risk of mortality (ROM)
• 74% voluntary adoption among hospitalists during the pilot
• Comprehensive AI chart review that increased hospitalist efficiency, prevented harm, and promoted operational and financial sustainability

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About Sentara Health

Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country. Founded in 1888, it operates 12 hospitals in Virginia and northeastern North Carolina, Sentara Medical Group with more than 1,500 providers, and Sentara Health Plans, which serves more than 1 million members in Virginia and Florida. Sentara is recognized nationally for clinical quality and safety, and was named to IBM Watson Health's "Top 15 Health Systems" in 2021 and 2018.

The challenge

Sentara faced three connected problems:

• Data it couldn't use. The health system was unable to fully leverage the data in its electronic health record to improve patient care.
• Workflows that wore clinicians down. Inefficient EHR workflows and data overload were contributing to hospitalist burnout and moral injury.
• Documentation that left revenue on the table. Incomplete, nonspecific documentation across a diverse patient population meant missed revenue opportunities.

Regard addresses the root cause of all three: leveraging data in the EHR to promote effective and efficient patient care. "It's about helping make hospitalists more efficient and confident when synthesizing large amounts of information," says Joseph Evans, MD, FACP, vice president and chief health information officer at Sentara. "The goal is to reduce burden and improve patient care quality and safety."

A diagnosis no one was looking for

Colin Findlay, MD, a hospitalist with Sentara, was face-to-face with a patient admitted for uncontrolled heart failure and rapid atrial fibrillation. He suspected medication nonadherence was the cause. After combing through previous hospital progress notes, he found nothing to indicate otherwise.

The AI tool Sentara was piloting told a different story.

Regard performs a comprehensive review of structured and unstructured data in the EHR, then curates and recommends diagnoses. In this case, it reviewed the patient's primary care office visit notes and surfaced hyperthyroidism — a condition that, left untreated, causes a rapid heart rate. Findlay immediately checked the patient's medication list and saw that the primary care physician had paused the medication several months earlier. It had never been resumed.

"I wouldn't have even known to look for that diagnosis," recalls Findlay, who now serves as an Associate CMO.

"I missed it in my initial assessment, and I would have likely missed it throughout the patient's stay. Without Regard, physicians may be unaware of diagnoses that impact the reason patients are in the hospital. If we miss these diagnoses due to copious documentation and a clunky EHR, that limits our ability to provide high quality care."

Findlay says there are countless examples where Regard helps him provide better patient care — surfacing important diagnoses, identifying critical antibiotics that had not been reordered, and preventing medication errors.

Why Sentara chose Regard

Sentara evaluated several AI tools for real-time clinical documentation support. What set Regard apart was its ability to suggest diagnoses, link to the supporting documentation, and format a progress note with the relevant details ready for review. Regard is flexible and adapts to other note creation workflows.

"I like the fact that I don't need to go back and forth throughout the record. It's one workflow," says Findlay. "Regard looks at everything in the chart and shows us much of what's relevant. It shrinks my blind spots and helps me provide better care."

From a seven-month pilot to enterprise-wide adoption

Regard's impact on patient safety during a seven-month pilot ultimately prompted Sentara to deploy the technology enterprise-wide, with a 74% voluntary adoption rate among hospitalists.

Evans has described the early wins as the turning point; cases involving sepsis, patients who should have been receiving antibiotics, and patients who should have been receiving prevention for blood clots. Those safety stories are what moved clinicians at other sites to ask for access.

Sentara has since rolled Regard out across all 12 of its hospitals, adding generative AI functionality for clinical summaries and discharge notes. Evans told MedCity News it was "one of the easiest implementation-to-adoption things that I've done" as CHIO, a notable comparison from someone who deploys Epic upgrades twice a year.

"Regard's real value is that it improves patient care. It shows me information in the chart I would not have found on my own. Sometimes this is information that's critically important and that completely changes the course of management." — Colin Findlay, MD, Associate CMO, Sentara Health

Impact on revenue integrity

In addition to promoting high-quality patient care, Regard enables Sentara to support revenue integrity across its diverse patient populations. By suggesting diagnoses — many of them CCs and MCCs that required clinical attention — Regard helps validate SOI and ROM more accurately. CC/MCC capture rose 17%, enabling up to a 4X ROI per user.

"It's about helping us get paid for the work we provide," says Evans. "To ensure revenue integrity, we need accurate and complete documentation."

The sequence matters. Clinical accuracy came first; documentation accuracy and revenue integrity followed from it.

Where Proactive Documentation moves the needle

• Improved diagnosing. Regard reviews all available data so vital diagnoses don't get overlooked or spotted too late.
• Improved care transitions. Continuity during handoffs, with the relevant details clinicians need to get up to speed quickly.
• Increased medication safety. Catching mistakes like accidentally discontinued medications or double-dosing.

Sustainability and what comes next

Findlay frames Proactive Documentation as a way to offset the staffing shortages every health system is contending with. Clinical teams are asked to accommodate higher volumes of complex patients with the same or fewer staff, without jeopardizing safety or quality.

"Healthcare is coming to a breaking point in terms of sustainability," he says. "Delivering care is so expensive, and hospital margins are shrinking. Without these tools, I don't know how the healthcare system will move forward."

As Sentara continues to expand its use of Regard, governance remains the priority. "The transparency Regard provides in terms of its algorithms for suggested diagnoses is very important," says Evans.

Findlay agrees. "There's a lot of national scrutiny regarding the use of AI and large language models in healthcare," he says. "However, this is the future, and Regard is an advancement we already depend on."

Sentara and Regard in the press

• Sentara Health Scales Its Use of Regard's AI Following Strong ROI & Clinician Adoption — MedCity News, July 2025
• These 3 Changes Must Occur for Hospitals to See Greater ROI from Their AI Investments — MedCity News, March 2024
• How Hospitals are Applying AI with Nate Wilson and Dr. Joe Evans — MedCity Pivot podcast

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