Hackensack Meridian nurse ‘on tour’ to roll out Ekam AI tool

The basics:

• Hackensack Meridian Health launched Ekam, a generative AI tool built on Google Cloud
• AI summarizes complex clinical notes in under a minute
• Nurse Margia Fonseca leading soft rollout of the agent to fellow health care professionals
• System plans broader AI expansion to support care teams and reduce burnout

Ekam is a Sanskrit word that means one source of truth. For Hackensack Meridian John Theurer Cancer Center nurse Margia Fonseca, it translates to personal assistant.

Fonseca is on tour presenting to sold-out crowds. Tapping into her inner Charlie XCX, she’s leading a soft rollout of Hackensack Meridian Health’s generative AI agent to nurses. Her approach to introducing how to harness the time-saving tech is generating buzz, building bridges across departments and generations.

For HMH, the rollout reflects a broader push to scale AI across its 18 hospitals, more than 500 sites and 36,000 employees.

Live since the summer, Ekam integrates directly into patient charts at Hackensack Meridian Health to rapidly read and synthesize complex provider noes, activated with the touch of a button. “It’s like a nurse-informed clinical support tool that organizes complex information in a way that mirrors how staff think on shifts,” Fonseca told NJBIZ.

In 2023, Hackensack Meridian Health announced an expansion of its strategic partnership with Google Cloud to deploy generative AI. The move sought to improve care for patients as well as reduce the burden on health care practitioners and operators.

At the time, the provider targeted three focus areas:

• creating an equitable patient experience and improving health literacy;
• enhanced clinical decision-making support; and
• greater administrative efficiencies

Revolutionizing care

Google Cloud said health care administrative costs in the U.S. increased by $18 billion in 2022, or 30%, over one year.

With its AI adoption, HMH aimed to help automate manual and repetitive tasks, alleviating employee burnout and allowing staff to focus on patients and improving the overall experience.

“Generative AI has the potential to revolutionize how we deliver care, making it more efficient, personalized, and effective,” Hackensack Meridian Health CEO Robert Garrett said in a news release announcing the Google Cloud expansion.

Since then, HMH’s Cloud Data Platform Ekam, built on Google Cloud, has started making the rounds. The assignment was to deliver “clinicians rapid, on-demand insights into their patients’ clinical data.” In a case study published before its deployment, Google Cloud noted how quickly the AI tool could analyze patient data. According to the report, it was able to immediately digest 100 pages of information, including clinician notes.

“We’re so busy with everything,” Fonseca said. “Because I have so many patients and I have things to do. But at least I can offset this with this note summarizer.”

Looking ahead, she’s also ready to further embrace and explore the tech. “I would hope one day, let AI write my note for me, let it do all that redundant stuff so I can focus more on my patients and the work I do.”

Burnout

Nurse burnout and “compassion fatigue” are often cited as top contributors to the persistent nursing shortage in New Jersey and nationwide. The condition afflicts a significant section of the workforce, nearly one-third of RNs across the U.S. Studies point to several contributing factors. Among them, higher patient counts, the cost of living and lower job satisfaction.

Giving time back to nurses could present a step in the right direction toward redirecting attention away from administrative tasks. And AI is a leading facilitator in making that happen.

A new Wolters Kluwer study found 72% of surveyed nurses see administrative burdens as a major impact on the profession. Meanwhile, 45% see promise in generative AI. Those respondents say they think it can take on lower-value tasks to help stymie burnout.

The survey also showed strong alignment on where organizations’ priorities lie:

• addressing staffing shortages (82%)
• generating administrative efficiencies (77%)
• reducing burnout (76%)

At HMH, the rollout of generative AI for clinicians touches on each of those points.

How it works

Ekam uses Google Cloud’s Vertex AI platform, which supports Health Insurance Portability and Accountability Act (HIPAA) compliance. It leverages machine learning to read and synthesize complex provider notes in under a minute. About 45 seconds, according to Fonseca.

“It’s not taking over your job. It’s not taking critical thinking. It’s just doing the reading for you and [the] redundant task,” she said, later adding, “It’s giving you the main points I want to know about a patient right away.”

Fonseca says at the end of the day, Ekam is here to help. “It’s going to save you a lot of time so you can actually spend more time with you patients and doing hands-on work.”

It’s not taking over your job. It’s not taking critical thinking. It’s just doing the reading for you and [the] redundant task.
– Margia Fonseca, Hackensack Meridian John Theurer Cancer Center nurse

Inspired by a screening of “The Imitation Game,” Fonseca says she’s been interested in technology since nursing school. She first got involved with the data science team at Hackensack Meridian Health in the fall of 2024, following an event hosted by the group.

“I connected with [HMH Director of Software Engineering and Data Science] Mike Stubna … he was talking about this new tool. They let me take part in their pilot program and template.” That was in January 2025, Fonseca said.

To help develop the oncology Ekam template, she created a specific set of questions for the data science team to test — the top things she wants to know about an oncology patient. For instance, past chemotherapies or reactions to other drugs.

She said internal policy at HMH allowed her to use random charts to test the template for educational purposes. In practice, Fonseca said Ekam does not require patient acknowledgement because it is only used by staff.

Once cleared, the team established the roster as a set able to be employed by HMH users across the system.

Hitting the road

Fonseca hit the road last July.

Beyond the cancer center, the list of facilities she’s traveled to, so far, includes Hackensack University Medical Center and JFK University Medical Center, with planned stops for Jersey Shore Medical Center and Bayshore Medical Center.

Veering away from the traditional HMH blue, to stay true to herself and the folks she hoped to engage, she adopted bright green and simple black font, inspired by the “Brat” album and tour. The invites for her sessions employ the color scheme, and even lyrics from the massive 2024 album. She said people pick up on those touches.

And it’s all about getting their attention.

“In my world, everything is based on music. I’m following what they’re doing and I’m doing it now for marketing here at HMH,” she said.

She stressed the importance of her face-to-face rollout. She likened it to the impact of touring musicians. “Better go out there and go on tour, because that’s how the masses are going to see it. That’s how … [they] are going to know every lyric of that song and understand it better.”

“So I’m going on tour throughout sites and showing people interactive – live – what this thing does.” She can also assist units with creating templates for specific departments.

Building a fan base

So far, Fonseca says she has racked up rave reviews from the “fans” that come out. And as a sort of ambassador for Ekam, the facetime also offers her an opportunity to engage in direct discourse about the technology with its intended users.

“I think it’s very integral that we have more health care professionals as part of this process from the get-go,” she said. “Don’t just make an AI product and tell us at the end, here you go. You need to have us as part of step one … because you’re not using the tool. We are.”

“[Y]ou’re not boots on the ground,” she added. “You’re not working with eight to nine patients. You’re not missing or not taking a lunch break. You’re not staying behind an hour doing charting.”

As a nurse, Fonseca says she’s able to connect with HMH’s nursing staff in a way that the data science team can’t.

In rolling out Ekam and the training around it, Fonseca offers a bridge between the disciplines. “We have to coexist,” she said of the clinician and technical sides of things. “It’s kind of like Aerosmith – [from the] rock world – and Run DMC,” she explained, referencing the 1986 crossover hit “Walk This Way.”

Connecting across generations

Fonseca has been able to connect across generations in the workforce, too. The back and forth helps to incorporate the institutional knowledge these seasoned – or perhaps less tech-proficient – professionals have to offer.

A 2026 workforce analysis from the New Jersey Collaborating Center for Nursing notes the mean age for a registered nurse in New Jersey is 49, with a sizeable set approaching retirement age (22% ages 56–65; 13% ages 66–75).

“They’re giving me ideas for what we could use to improve our new tools,” she said. “Maybe we should add a lab component to the Ekam. Have it tell us if a male’s PSA, prostate specific antigen, gets too high; we can track it to screen quicker for prostate cancer.”

Something for everyone

That can only make the program better. Ekam is only as good as the information that is available to it. Fonseca stressed how that necessitates providers, such as physicians and nurse practitioners, sharing information in a timely manner.

She also takes the ideas she receives back to the data science team. “Because we can create new tools based on what I’m hearing,” she said. “That’s the beauty of going on tour — unique fans along the tour; they’re giving you ideas for a ‘new song.’”

Like other conversational AI, Ekam collects feedback from users, utilizing a thumbs up and thumbs down response to answers generated, as well as the ability to submit experience comments. Fonseca said the feedback goes directly to data science.

According to HMH, Ekam is currently active across all units at John Theurer Cancer Center, as well as parts of JFK University Medical Center: the Magnet committee, same day surgery, preadmission testing and PACU.

Beyond nursing, she also sees potential benefits from Ekam for other health care professionals, citing social workers and physicians.

“This has happened before in my past: A breast cancer patient called saying, ‘I don’t want to live anymore.’” She noted that on call social workers don’t necessarily have familiarity with the patient — or the time to read through their entire history, adding, “Let Ekam do it. It might pull up their history – ‘I have suicidal tendency, depression, bipolar’ – all these things right away, while somebody’s on the other line calling the police for a wellness check.”

“I want people to know it’s not just for nursing; it’s for every specialty.”

Next-gen care

Last October, HMH detailed several new AI agents built with Google Cloud generative AI technology. According to Google, Hackensack Meridian is the first health system to deploy an agent built on Gemini at scale for clinical note summarization.

“As an organization, we have hyper-scaled our AI-enabled capabilities over the past three years, and putting these agents into production represents the next frontier in our journey,” said Sameer Sethi, senior vice president, chief AI officer, Hackensack Meridian Health.

Since rolling out in June 2025, Sethi said the feature has helped more than 1,200 clinicians generate over 17,000 summaries. Additionally, he said usage is growing. “By using Gemini to summarize clinical notes for more than 12 specialties, we’re freeing up pajama time, reducing physician burnout and empowering care teams to create a more personal experience for every patient,” he said.

Developments to improve the patient journey included a NICU nurse agent and a lab values summarization agent.

“Hackensack Meridian Health is not simply adopting AI; they are establishing the blueprint for the next generation of value-based care,” said Aashima Gupta, global director, Healthcare Strategy & Solutions, Google Cloud.

What’s next?

What does success look like a year from now for Fonseca? More tour stops, more templates, and more time spent talking with nurses. “I hope to get more inspiration and maybe more AI tools created by nurses for nurses in the years to come,” she said.

More than anything else, Fonseca said she hopes HMH nurses know she’s ready and willing to bring the Ekam tour to them to help make work more manageable. “Just send me an email … I’m hoping to come see as many people on tour as possible.”

Looking ahead, HMH plans to continue to expand its use of AI into clinical decision support.

According to the health system, future tools will analyze current and historical patient data to glean patterns and decipher certain diagnostic and prognostic indicators that can be used to predict which patients may require a different care setting.