The Shark Tank Competition session showcased innovative, early-stage ideas aimed at addressing operational, educational, and equity challenges in hospital medicine. Structured as a pitch-style forum, presenters shared novel solutions and received real-time feedback from expert “sharks,” including leaders in hospital medicine, systems design, and healthcare innovation. The session highlighted the growing importance of creativity, interdisciplinary collaboration, and implementation science in solving complex healthcare problems.
The session opened with an update from the 2025 Shark Tank winner, Devin Horton, MD, who described progress on a partnership between an academic hospitalist group and a rural community hospital. His project addressed a critical and increasingly common mismatch in healthcare delivery: overcrowded academic centers with boarding patients alongside struggling rural hospitals facing closures and declining community trust. Through intentional partnership-building focused on culture, trust, and process improvement, the collaboration aimed to redistribute patient care more effectively while strengthening rural healthcare infrastructure. Early outcomes demonstrated an increase in case mix index (CMI), suggesting improved capture of patient complexity, though Centers for Medicare and Medicaid Services ratings declined—highlighting the nuanced trade-offs that can accompany system-level interventions.
A key lesson from this update was the importance of anticipating parallel system changes. Dr. Horton noted that additional partnerships were already underway, unbeknownst to him at the outset, emphasizing the need for alignment across stakeholders. The experience underscored that rebuilding trust—particularly in communities where hospitals have faced closures or acquisitions—is as critical as operational efficiency. Ultimately, the project illustrated that academic–rural partnerships will likely be essential in addressing capacity constraints and maintaining access to care.
The first formal pitch was delivered by Ruchi Doshi, MD, from Duke University in Durham, N.C., who introduced “Transfer Center Tycoon,” an interactive educational platform designed as a “serious game” to train residents in managing transfer center calls. This is a high-stakes but low-frequency skill that many trainees feel unprepared for. The platform simulates real-world transfer scenarios, allowing learners to gather clinical information (history, exam, labs, imaging), make triage decisions, and determine when to involve consultants. Importantly, the game incorporates operational considerations such as hospital capacity, forcing trainees to balance clinical judgment with system constraints. Users receive performance feedback, including efficiency metrics that penalize excessive time spent and reward timely decision making.
Survey data presented showed that a significant proportion of residents lack confidence in handling transfer calls, and approximately two-thirds reported that the game provided valuable exposure to scenarios they would otherwise rarely encounter. The platform is customizable, allowing institutions to tailor scenarios based on local workflows and clinical priorities. Dr. Doshi’s team sought guidance on how to validate the tool’s impact on real-world performance and how to scale dissemination while maintaining financial sustainability. Feedback from the sharks focused on defining the target market, establishing measurable outcomes, and addressing potential bias in scenario design. The discussion highlighted a broader challenge in medical education innovation: demonstrating that simulation-based learning translates into improved clinical outcomes.
The second presentation, from a group at Levine Children’s Hospital in Charlotte, N.C., addressed the “tech equity gap” in pediatric hospital-at-home programs. The presenters outlined a growing crisis in pediatric inpatient capacity, noting that since 2008, approximately one-third of pediatric units have closed, reducing available beds for hundreds of thousands of annual admissions. Hospital-at-home models offer a promising solution by delivering high-quality care in the home environment, but pediatric adoption has lagged behind adult programs. A major barrier is the lack of child-appropriate technology. Current monitoring devices are often not designed for pediatric patients, limiting scalability and safety.
The group proposed the development of hospital-grade, wearable, pediatric-specific monitoring devices capable of wireless data transmission to centralized hubs or the electronic health record. Their vision included child-sized sensors with reliable connectivity, enabling continuous monitoring for conditions such as bronchiolitis, pneumonia, dehydration, and skin or soft tissue infections. They emphasized that patient selection would remain critical, with programs offering home hospitalization only to families deemed safe and appropriate. The presenters sought advice on engaging industry partners and securing investment to close this technology gap.
Shark feedback centered on clarifying target populations, defining eligibility criteria, and generating evidence to support safety, acceptability, and outcomes. Questions also addressed scalability, reimbursement, and the complexity of coordinating multiple stakeholders, including device manufacturers and healthcare systems. The discussion reinforced that while hospital-at-home represents an exciting frontier, successful implementation requires robust infrastructure, clear patient selection frameworks, and strong partnerships with industry.
The final pitch, presented by Alan Moazzam, MD, from UC San Diego in San Diego, focused on leveraging artificial intelligence to optimize patient distribution workflows. Titled “Hey Alexa, Distribute My Patients,” the project addressed a common pain point for nocturnists: assigning overnight admissions to day teams fairly and efficiently. This process is often manual, time-consuming, and cognitively burdensome, particularly during early morning hours when competing demands—such as reviewing labs and responding to pages—are high.
Dr. Moazzam’s team developed a prototype using artificial intelligence integration (via tools such as Copilot and OpenAI) to automate patient assignment. The system incorporates a proprietary clinical deterioration score to balance patient acuity across teams, aiming to improve equity and workload distribution. By aligning assignments with patient complexity rather than simple census counts, the tool has the potential to enhance both patient care and provider well-being.
While initial prototypes demonstrated feasibility, challenges remain, including improving accuracy and validating the impact on clinical outcomes. The sharks raised important considerations, including the inability to patent such a system (though copyright may be possible), the need for outcome data (e.g., length of stay, burnout, patient outcomes), and the importance of integrating geographic factors into assignment algorithms. This project highlighted the growing role of artificial intelligence in hospital operations and the need for rigorous evaluation before widespread adoption.
Overall, the session emphasized that innovation in hospital medicine extends beyond clinical care to include education, operations, and health equity. Across all presentations, common themes emerged: the importance of defining measurable outcomes, anticipating implementation barriers, and engaging stakeholders early. The session also reinforced that even the most promising ideas require iterative refinement, validation, and strategic planning to achieve meaningful impact.
Key Takeaways
- Innovative solutions in hospital medicine must demonstrate real-world impact, improving patient outcomes, operational efficiency, or trainee education, to achieve adoption and sustainability.
- Partnerships (e.g., academic-rural collaborations or healthcare-industry alliances) are essential for scaling solutions, particularly in addressing capacity constraints and technology gaps.
- Emerging tools like simulation-based education and AI-driven workflows show great promise but require rigorous validation, attention to bias, and thoughtful integration into existing systems.
Dr. Beshay
Dr. Beshay is an assistant professor of medicine and assistant director of education at Emory St. Joseph’s Hospital in Atlanta.