How Sentara adapted clinical AI for case management

Building AI around case managers' needs

When it became clear that case managers needed more support, the health system examined existing options, including tools from its EHR vendor, Epic.

"We felt that looking at those tools, they were not providing the quality of data that our case managers needed in a timely fashion," Reeder said.

So, Sentara approached Regard about adapting its chart-review capabilities for case managers, Nate Wilson, president and co-founder of Regard, said. The health system had been using Regard to support hospitalist documentation up until that point.

"We said, let's understand the fit, the use case, the value. And very quickly, we scoped out a pilot together," said Wilson.

Sentara gathered input from frontline case managers before and during the pilot. Some case managers received early training and helped guide development.

The first version of the tool used a single prompt to give case managers the information needed to complete their initial assessment, including the patient's clinical journey, risk factors and current status. During the pilot, case managers asked for a summary of changes over the last 24 hours. In response, Regard added a second prompt.

"They really leaned into product development. We worked iteratively with Regard. So we had opportunities to improve as we went along," Reeder said.

According to Sentara, that second prompt is now the most used, particularly on Mondays, when case managers need an update after the weekend before starting discharge rounds.

Finding answers within the medical chart

Case managers access the AI tool within the EHR, where they can use the prompts or ask plain-language questions about a patient's history and care. Ambulatory case managers can also query the chart during virtual patient interactions, helping them answer questions without an extended search, Reeder said.

The tool draws on the patient's medical history across current and past encounters, including information from outside the health system available through health information exchanges and Epic's Care Everywhere, Wilson said. The tool uses diagnostic algorithms to assess clinical information and a large language model to present the findings in plain language, helping case managers understand the patient's clinical picture. The case managers can also verify details about the patient through citations linked to the chart.

"When a clinician or a case manager clicks on a citation, it will show them the raw data, the base form, where it came from, all of that is fully inspectable," Wilson said.

As case managers grew familiar with the tool, they began exploring how it could support other parts of their work. Wilson said case managers' use of the tool began to expand to tasks such as denial appeals, admission status and discharge placement.

Early results and measurement challenges

Sentara deployed the inpatient tool in summer 2026 to approximately 250 case managers, and today, more than 90% use it regularly, Reeder said. Broader deployment among ambulatory case managers remained under negotiation at the time of the interview. 

According to a Sentara press release shared via email in October, estimates based on data from the pilot show that deploying the tool across acute and ambulatory care could save nearly 90,000 work hours, equivalent to more than 40 full-time employees, and nearly $5 million in labor costs.

In the ambulatory pilot, patient encounters increased 6%, and the number of patients managed rose nearly 20% between April, before the pilot, and June, Sentara said. But activity returned toward its previous level after Sentara withdrew access while considering expansion.

"So genuinely, while it was a relatively small pilot initially, the fact that they reverted after we took the tool away is kind of the strongest evidence that I have that it genuinely was this tool that made that big of a difference," Reeder said.

But impact on the inpatient side is harder to measure, though anecdotal feedback is positive. Sentara is still evaluating how the tool is affecting inpatient case management and patient outcomes, Reeder said.

Ambulatory case managers can contact additional patients when time allows, while inpatient teams serve only those currently hospitalized, so the hours staff spend with patients are difficult to measure. For instance, if an AI tool reduces hours spent in chart review, inpatient case managers could spend that time with patients and families instead, but the number of encounters would not change.

The teamwide rollout on the inpatient side also makes the tool's contribution difficult to isolate, so the health system is developing a dashboard to better track case management activity, Reeder said.

Sentara has also struggled to hire enough case managers to provide the level of support it believes patients need, Reeder said. So, with the new tool, Sentara aims to help its existing staff reach more patients.

Further, the project underscored the value of giving case managers greater consideration in technological planning.

"There seems to be a real benefit to engaging more strongly with case management and providing them tools," Reeder said. He encouraged organizations to consider "the whole care team and not just the people that immediately come to mind."

"It's a worthwhile thing to do because those people have important jobs that really can impact patients' lives," he said.

Elizabeth Stricker, BSN, RN, comes from a nursing and healthcare leadership background, and covers health technology and leadership trends for B2B audiences.