healthsystemCIO – Strategies for Hospital IT Leaders

Dr. Sarah Pletcher, Chief Digital Health Officer and System Vice President, Executive Medical Director for Strategic Innovation at Houston Methodist, discusses how health systems build the business case for large technology projects. She recommends agreeing with finance on two metrics to track, explains how retention gains can count as avoided costs, and describes phased budgets that fund adoption. She also covers Houston Methodist's OR computer vision deployment.

Molly McColl, Vice President of Virtual Health and Clinical Transformation at Advocate Health, explains how Care Model Engineering supports the move from individual pilots to systemwide programs. She describes defining expected outcomes, reusing screening-program standards and evaluating clinical tool requests against the existing technology stack first.

Matt Seul, Principal Information Security Architect at Sutter Health, shares lessons from building an AI tool that scans code for security flaws. An initial version produced results in about half an hour; generally stable output took about three months. He explains a file-processing tool call that used about 12,000 tokens with a Python script, the risks of long sessions, and why he uses medium reasoning for orchestration and heavy reasoning for code analysis.

Sachin Pawar, MD, Surgical Medical Informatics Officer at Froedtert Health, explains why a surgeon with dedicated informatics time can bridge EHR analyst teams organized by application when surgeons work across all of them. Pawar describes how Froedtert moved surgical case entry to surgeons and clinical team members and met its 80% target, and how a surgical governance subcommittee screens requests before IT builds them.

Ryan Cameron, EVP, Chief Information & Innovation Officer, Children's Nebraska; Ryan Curl, PhD, AI Governance Lead, SUNY Upstate Medical University; Pete D'Addio, VP of Technology, LCMC Health; and Brian Dilcher, MD, Associate CMIO & Director of Emergency Medicine Clinical Informatics, WVU Medicine, discuss how health systems control AI token costs without asking physicians to count tokens. They cover flat-fee AI pricing that can shift to tokens, contract milestones and budget limits.

Ryan Smith, SVP, Chief Digital & Information Officer at Intermountain Health, discusses the AI triage agents his team began building weeks before Epic go-live. Within about a week, the agents began outperforming a 40-person informatics team in seven or eight application areas, freeing most of the team for at-the-elbow support. Smith explains why clean ticket history, clear ownership and demonstrated performance matter before agents enter production.

Kory Hudson, MBA, CHCIO, CIO of Baptist Health Care, discusses the Pensacola, Fla., system's move from Sunrise to Epic, approved in June with go-live planned for 2028. Hudson explains why a late start lets Baptist build on Epic's standard content and go live on the newest release, how patient-centered guiding principles will decide which specialty systems stay outside Epic, and why he expects to staff the implementation without consultants.

Chuck Christian, VP of Technology/CTO at Franciscan Health, discusses why the cost controls health systems built for the cloud do not extend to AI. He describes the Cloud Cost Analyst role he created in 2023, the weekly report it produces, and a workload move projected to save about $50,000 a month. He also covers chargeback, token metering, and what happens when outside agents start querying health system APIs at volume.

Matthew Kull, EVP, Chief Information and Digital Officer at Inova Health, discusses why walling scheduling data off from large language models costs health systems appointments. He reports API calls from ChatGPT into Inova's Epic environment have skyrocketed, warns peers to expect a 10X jump in API fees, and explains the autonomy line separating Inova's agentic call center, now handling 400,000 calls a month, from its human-in-the-loop clinical AI.

Chris Tyberg, chief information security officer at Abbott and chair of the Health Sector Coordinating Council Cybersecurity Working Group, explains why polling application owners produces unusable downtime plans and what business process owners answer instead. He shares early findings from Operation Vital Signs, the first sector-wide healthcare cyber tabletop, including why sustained response strains organizations far more than the opening hours and how the third-party contact gap still runs on relationships.