Ardexia Podcast: Healthcare Change for the Better

Primary care physicians were spending two to ten hours after their clinical day renewing medications in the portal. Work that generated nothing and had nothing to do with why anyone went to medical school. MedStar did something about it.

Dr. Ethan Booker is the Chief Medical Officer for Telehealth at MedStar Health and has been building connected care programs since 2015. In this episode we get into the APP model that solved the pajama time problem, why adoption variability had nothing to do with payer mix or patient age, what close to a million ambient AI notes actually taught them about adoption, and why intention to stay scores moved in synchrony with the program rollout.

If you are building connected care programs, deploying ambient AI, or trying to understand why your adoption numbers are not moving, this one is for you.

Most digital health implementations don't fail dramatically. They just quietly stop. No complaints, no pushback, just people going back to their old workflows while the dashboard shows everything is fine.

Anniina Mustikkamaa is a registered nurse, paramedic, and project manager at Western Uusimaa Wellbeing Services County in Finland. She built a change management program from the ground up inside a large public health and social care organization, not by bringing in outside consultants but by turning the people who already understood the system into the face of change.

In this episode we get into why quiet failure is the most dangerous kind, what giving every person in an organization a specific human to contact actually does for adoption, and why change management is even harder on the social care side than most organizations account for.

If you have ever watched a go-live look fine and then realized six months later that nobody was actually using it, this one is for you.

Most digital health programs never cross the threshold where adoption becomes the norm. The pilot runs, the enthusiasts show up, and then nothing moves. National telehealth usage sits between 5 and 10% after the biggest forced adoption event in the history of digital health. Jefferson Health was the outlier. This episode is about why.

Dr. Aditi Joshi is the founder of Ardexia and an emergency physician who has spent fifteen years building and evaluating digital health programs across three continents. In this episode she breaks down why compliance is not adoption, what the Magic Third means for implementation strategy, and what it actually takes to change conditions until adoption becomes the path of least resistance.

Half of patients who receive a digital therapeutic prescription never download the app. The prescription exists. The reimbursement exists. The clinical evidence exists. The patient never gets there.

Stéphane Tholander has spent fifteen years building digital health companies in France and he is direct about what is not working. He co-founded the first French company to receive CE marking under the new medical device regulation and built AppThera to close the gap between good tech and actually using it.

In this episode we get into why your payer not being your user breaks most digital health business models, what France's regulatory system produces that the US market does not, and what regulators are still getting wrong about AI right now.

"Bureaucracy isn't always a bad word."

In this episode of Ardexia Insights, Dr. Aditi Joshi speaks with Dr. Lloyd McCann, CEO of Tamaki Health in New Zealand, about his unique journey from military leadership to healthcare innovation. They discuss the importance of effective leadership, the challenges of bureaucracy, and the need for a consumer-centered approach in health system design. Dr. McCann shares insights on leveraging digital technologies and the significance of a national health identifier in improving patient care. The conversation highlights the exciting transformations happening at Tamaki Health and the broader implications for healthcare systems worldwide.Takeaways- Leadership in healthcare drives innovation and change.- An 80% plan delivered on time is more effective than a perfect plan delivered late.- Bureaucracy can facilitate change when managed well.- Decentralized decision-making leads to better patient outcomes.- Health systems must be designed with consumer-centeredness in mind.- Data access is crucial for improving population health.- 90% adoption of new technologies is achievable with the right approach.- Engaging clinicians in the change process is essential.- Transforming healthcare requires both macro and micro considerations.- Optimism and enthusiasm are vital for driving healthcare innovation.Chapters00:00 Introduction to Healthcare Innovation01:27 Military Leadership Lessons in Healthcare04:44 Navigating Bureaucracy and Digital Innovation08:13 Designing Health Systems for the Future14:26 Value-Based, Digitally Enabled Health20:50 Exciting Transformations in Tamaki Health

In this episode of Ardexia Insights, I’m joined by Dr. Resa E. Lewiss, a Harvard-trained ER physician and a pioneer in healthcare system design. We aren't talking about aesthetics; we’re talking about the deep change management required to align physical space, digital workflows, and clinical reality.

What we tackle in this conversation:

• The EHR-Ultrasound Gap: Why point-of-care tech fails when the "design" doesn't account for how data actually flows into the chart.

• The Architect-Clinician Disconnect: Why your billion-dollar hospital wing might actually be hindering patient care from Day 1.

• Human-Centered Reality: Moving past the buzzwords to see how ICU redesigns at places like Beth Israel actually impact clinician efficiency.

• Global Adaptability: Lessons from Malawi on why "elegant" design must survive in low-resource, high-stress environments.

As Resa points out, every "innovation" has a trade-off. If you don't intentionally design the environment, you are tacitly accepting a burden that your staff will eventually have to carry.

Welcome to Episode 7 of the Ardexia Podcast where we speak to leaders, clinicians and advocates for better healthcare. This week, we talk to Dr. Minal Shah, a hospitalist, physician informaticist, and health technology leader at CommonSpirit Health, one of the largest health systems in the US, where she supports more than 25,000 providers.In our latest Ardexia Insights conversation, Minal and I explored what happens when organizations understand trade-offs versus when they chase innovation without understanding ecosystem impact:→ Why clinical judgment and medical knowledge are different things→ How the patient portal inbox became a burnout driver→ What limits scaling (hint: it's operational, not technological)→ Why off-ramps matter as much as nudges in clinical decision support.Technology doesn't have silver bullets. Every digital health solution involves trade-offs. Organizations that don't understand this create new problems while solving old ones.Dr. Minal Shah designs and implements clinical workflows at scale across EHRs, virtual care, and applied AI. Her North Star is protecting clinical judgment and the patient-physician relationship as healthcare becomes more digital. She focuses on ensuring technology earns its place by reducing cognitive burden, strengthening trust, and enabling clinicians to practice medicine more effectively.The conversation revealed what happens when organizations understand trade-offs versus when they chase innovation without understanding ecosystem impact.

A conversation with Dr. Nadeem Alduaij on what digital health leaders need to know about cultural context, clinician readiness, and sustainable implementation.When healthcare organizations pursue digital transformation, they typically focus on selecting the best technology. But what if the real challenge isn't choosing the right system but understanding whether any system can work in your specific context?Dr. Nadeem Alduaij has spent 20 years building and advising health systems across Kuwait, Switzerland, and the United Arab Emirates. His experience reveals a pattern that should concern every digital health leader: technological capability without contextual fit creates expensive failures, no matter how innovative the solution.In a recent conversation for the Ardexia Insights series, Nadeem shared insights that challenge conventional approaches to healthcare innovation and offer a roadmap for more successful implementations.

In this episode of Ardexia Insights, Dr. Aditi Joshi speaks with Dr. Matt Sakumoto about the evolving landscape of digital healthcare, focusing on virtual care, AI tools, and the importance of empathy in patient inIn this episode of Ardexia Insights, Dr. Aditi Joshi speaks with Dr. Matt Sakumoto about the evolving landscape of digital healthcare, focusing on virtual care, AI tools, and the importance of empathy in patient interactions. They discuss the challenges and opportunities presented by electronic health records (EHR) and AI, emphasizing the need for trust and evidence-based approaches in implementing new technologies. The conversation also touches on the future of medical training and the role of physician innovators in shaping healthcare solutions.teractions. They discuss the challenges and opportunities presented by electronic health records (EHR) and AI, emphasizing the need for trust and evidence-based approaches in implementing new technologies. The conversation also touches on the future of medical training and the role of physician innovators in shaping healthcare solutions.

takeaways

• The biggest disconnect is between physician workflows and patient expectations.
• Empathy in digital care hinges on trust and clarity of communication.
• AI scribes can significantly reduce documentation burden for clinicians.
• Successful AI tools should integrate seamlessly into existing workflows.
• Evidence-based approaches to AI must adapt to real-time data monitoring.
• AI tools can assist in clinical decision-making but require human oversight.
• The future of medical training will involve integrating AI tools effectively.
• Curiosity and problem-solving are essential traits for physician innovators.
• Defining the right problem is crucial for effective healthcare solutions.
• Building a community of physician innovators can provide valuable support and guidance.

70% of digital health investments see no ROI.Not because the technology doesn't work. Because pilots don't convert to revenue-generating contracts.In Episode 4 of the Ardexia Podcast, we explore why with Dr. Raihan Faroqui—who's closed $30M+ in enterprise deals and built four startups from zero to one.

For more information and insights follow us. We work on clinical validation, adoption and improvement of ROI for digital health. Contact us for more information at www.ardexia.io.