A new survey of the healthcare C-Suite finds that different executives have different ideas on governance. And they’re not sure about ROI, either.
A new survey of healthcare C-Suite executives finds that while many are taking a good look at generative AI, they’re not doing what they should to support scalability or sustainability.
The survey of 300 executives from American healthcare organizations, conducted by Accenture Managing Directors Tejash Shah and Kaveh Safavi and Health Industry Lead Researcher Daniel Owczarski, indicates 83% are piloting gen AI tools, but only 10% are investing in the data infrastructure needed to deploy the technology beyond the pilot.
There’s also a disconnect on who should oversee AI strategy. Some 28% of CEOs said they’ should be responsible for redefining jobs and roles impacted by AI, but only 5% of C-Suite executives agree. About 80% say the Chief Digital Officer or Chief Digital and Artificial Intelligence Officer should have that role, and less the 4% believe the CNO or CMO has any part to play in this.
“This perception overlooks a crucial reality: The labor shortage is most acutely felt by the clinical workforce, particularly nurses,” the report’s authors stated. “Clinical leaders will play a pivotal role in ensuring that gen AI-driven workflows deliver sustainable value and improved efficiency.”
“The true benefits of gen AI come from fundamentally changing how work gets done, which requires collaboration across leadership levels,” they continued. “Clinical leaders, such as CNOs and CMOs, should play a central role in redefining work models, identifying tasks for automation and empowering staff with tools that simplify their jobs. These efforts will help address the pressures faced by frontline teams and ensure that gen AI-driven solutions enhance care delivery.”
Who’s Piloting The AI Ship?
The biggest takeaway here is that health system and hospital leadership doesn’t appear to have a firm AI governance strategy in mind. They’re differing not only on who should be in charge, but downplaying the infrastructure needed to ensure growth.
Healthcare executives taking part in the HealthLeaders AI in Clinical Care Mastermind program have voiced those concerns as well. William Sheahan, SVP and Chief Innovation Officer at MedStar Health, said leadership has to understand how data is gathered, stored and managed to get a good handle on the transformative potential of AI. That may include investing in data management technology that hasn’t been updated in decades.
"How do we get our people, our nurses, our doctors, our clinicians, our revenue cycle teams, to understand how the technology supports the future of their work?" he told HealthLeaders during an interview last year. "We can't just focus on deploying the fun new technology and expect that organically it's going to change your business, right?"
The survey’s authors say the industry’s conservative approach to technology is playing a role in this disconnect. Only about half of the executives surveyed report strong alignment between the organization’s overall strategy and its technology goals. And while 60% expect an ROI for AI within a year, 95% are anticipating only moderate ROI over the next five years because they aren’t investing enough in the infrastructure needed to maintain that pace of growth.
“This underinvestment puts healthcare organizations at risk of falling further behind — both in meeting the growing demand for care and in keeping pace with competitors who integrate technology and strategy seamlessly,” the authors noted.
What To Do About ROI?
The survey also offers interesting insights into how ROI is being measured.
When asked how gen AI would impact healthcare, executives were bullish on administrative improvements but not so sure about either clinician well-being or clinical outcomes.
According to the survey, when asked how gen AI would improve their organization, 83% cited increased employee efficiency and 82% said the technology would drive revenue growth, yet only 17% cited improved clinical decision-making and only 6% said the tools would empower patients.
In terms of outcomes, 82% of those surveyed listed revenue growth, while 77% mentioned productivity gains, but only 20% cited employee satisfaction, 9% cited either cost reduction or employee retention, and 6% cited error reduction.
This goes against the grain for a vast number of health systems and hospitals launching AI scribes, many of whom are focused on reducing clinician stress and burnout and improving workflows. It could also point out that while many are targeting workplace well-being, the emphasis is still on financial ROI.
Mastermind participants Roopa Foulger, Vice President of Digital and Innovation Development at OSF HealthCare, and Jonathan Handler, MD, OSF’s Senior Fellow for Innovation, said healthcare leadership is struggling to understand what ROI really entails.
“How do we measure it?” Handler asked during a HealthLeaders interview last year. “How do we assess it? How do we validate it? And I think that gets harder, not easier, with some of the new large language models and the generative AI that’s out there. Because now, instead of algorithms built on a use case by use case basis, you’ve got this general purpose model – how do you evaluate all the things that it can do?”
“There are so many other ways to measure the value that is created,” he added. “Determining the right things to measure, which may not always be the easiest things to measure, is critical.”
Plotting The Right AI Strategy
In its report, Accenture offered four steps that healthcare executives should take to make sure they’re on the right path for AI development:
Build a reinvention-ready digital core. “Leaders should prioritize initiatives and technology investments such as enhancing data quality, democratizing data access, migrating to the cloud and building robust data governance frameworks,” the report said. “These actions will create a flexible and adaptive digital core, ready to support emerging technologies.”
Strengthen data quality and strategy. “Organizations seeing strong returns on technology investments prioritize centralized data management and data modernization,” the report noted. “They ask critical questions such as: Are processes and tools connected across functions to provide shared access to data and analytics? Is the data standardized, secure and easy to use?”
Prioritize responsible and secure AI deployment. “An organization’s readiness to scale gen AI depends on its ability to manage, mitigate and protect against these and related risks,” the report said. “Proactive strategies can minimize downtime and reduce the risks posed by evolving threats and expanding attack surfaces. Continuous monitoring and assessment of technological constraints, data integrity and cybersecurity measures are essential for building resilience and enabling faster, more efficient recovery in the event of an incident. Secure scaling of AI also requires deploying tailored LLMs and developing a workforce skilled in harnessing these tools.”
Expand your base of expertise beyond your own people. “Increasingly, external influencers are driving transformation across healthcare, helping shape standards and practices that promote innovative approaches,” the report said. “Healthcare providers partnering with academic institutions or leading researchers are already seeing tangible benefits. One such collaboration led to the development of advanced care protocols, resulting in reduced patient recovery times and higher satisfaction rates. This effort also attracted additional funding and support, accelerating innovation and establishing a robust framework for future advancements.”
There are major quantitative and qualitative benefits to CNOs and other nurse leaders focusing on nurse wellbeing.
HealthLeaders spoke to Diane Sieg, RN, CYT, CSP, registered nurse, author, coach, and creator of the Well-Being Coaching Initiative, about how CNOs can make the financial case for nurse wellbeing and prioritize wellbeing in their organizations. Tune in to hear her insights.
Duke Health CHIO Eric Poon says healthcare leaders can move quickly and fail fast, but they had better learn from those mistakes and adjust accordingly
The Duke University Health System is investing in roughly 80 AI products. And they're fine with the fact that not all of these tools are going to work.
"We know that not everything that we put our hands on or that comes our way is going to pan out," says Eric Poon, MD, MPH, FACMI, the health system's Chief Health Information Officer. "We don't ask for a mountain of evidence up front. Our governance philosophy is that we need to fail often and fail fast, so we provide just-in-time advice."
Welcome to what some have called the Wild, Wild West of AI in healthcare. It's a heady time to be an innovation executive these days, working with a technology that has strong potential to transform a troubled industry. But Poon, like so many of his colleagues in health systems and hospitals across the country, knows the path forward has to be managed just right. Mistakes are OK, but they had better be learning lessons.
"We openly tell our clinicians that AI is not perfect and AI is capable of making mistakes, so we as clinicians need to be responsible for everything that we take advantage of out of these products," he says. "In this case anything that we put in the chart, we need to take direct responsibility for, which means that we need to take very good care in reviewing the notes."
One example is ambient AI, in which Duke Health has partnered with Abridge to deploy a tool for physicians to capture the doctor-patient encounter. More than 1,200 clinicians in the health system are now using the tool.
Poon says clinicians have been using voice-to-text technology for some time, so the idea of capturing the doctor-patient conversation isn't entirely new. But with AI layered onto the process, the notes have more context and are more easily integrated into the medical record, potentially reducing the time spent by the doctor translating notes while enhancing opportunities to identify care pathways and coding.
Clinicians were given some training on how to use the technology, Poon says, but they were also given some freedom to integrate the tool into their own workflows.
As they become comfortable with the technology, Duke Health will look at how it can be integrated into other clinical pathways. Poon says this will include "workflows upstream and downstream from the generation of the note."
Therein lies the true benefit of working with AI. Accessing and analyzing more data gives clinicians the opportunity to better manage the patient's care journey—before, during and after the patient-doctor encounter. And while this data can unlock those opportunities to improve clinical care, clinicians have to be careful that the data being used is accurate and reliable.
The key to keeping track of the successes—and failures—is governance. Poon says AI governance was launched initially as a separate entity to technology governance, then quickly integrated when it became clear both were looking for the same things.
"We've figured out that you cannot have one single group squirreled away trying to perfect data," he says. "It needs to be a team sport, so we have a distributed data governance process and I think we in some ways take a risk-based approach."
Duke Health's approach isn't unique. While some healthcare organizations separate their AI governance, more health systems and hospitals are working those responsibilities into existing committees and workflows. Some simply don't have the time or resources to create more layers of governance, while others are recognizing that AI technology is fast becoming a part of many workflows.
Poon says healthcare executives need to understand that AI is advancing faster than many other technologies in healthcare, in part because the technology is easy to use and is being embraced just as quickly by consumers. The temptation for healthcare leaders is to move that quickly as well, which is why governance is so important.
"We've put a lot of time and effort" into responsible AI development, he says.
AONL 2025 is well underway as nurse leaders discuss AI, wellbeing, and DEI strategies.
After the first day of AONL 2025 in Boston, it's clear that CNOs and other nurse leaders have a few key concerns and focuses for nurse wellbeing, diversity, equity and inclusion (DEI), and tackling AI implementation.
Hesitations about AI
To no one’s surprise, AI is top of mind at the conference this year, and nurse leaders are feeling apprehensive. As the technology progresses, CNOs have to decide how and when to embrace it and incorporate it into workflows.
The nurse leaders participating in the discussion were concerned about documentation errors, transparency, and deskilling among the workforce. There were also ethical concerns about patient confusion when talking to a chatbot.
A new kind of mental health support
Nurse mental health continues to be a top priority for CNOs, as burnout and turnover rates remain high in many organizations. Yarisbell Collazo, DNP, RN, MLD-C, MEDSURG-BC, nurse manager at UF Health, helped implement a new program for mental health resource nurses (MHRNs), who can help staff deal with stress and mental health concerns at work.
Each MHRN specializes in a different skill, ranging from organization to de-escalation, confidence, anxiety, depression, and coping mechanisms. The nurses are certified in mental health first aid, and they provide monthly materials to staff related to mental health issues and themes. The goal is to make their roles official, so that they can dedicate more time to mental health education, which they are now taking on in addition to seeing patients.
Withstanding attacks on DEI
Under the waves of executive orders from the Trump administration, many organizations are hesitant to move forward with diversity, equity and inclusion (DEI) initiatives out of fear of noncompliance.
They also advocated for an inclusive excellence strategy based on Maslow’s hierarchy of needs, which begins with equality and results in human flourishing and self-actualization. The goal is to achieve equal opportunity for nurses while also prioritizing equitable patient care.
Prevention should be the priority to sustainably lower healthcare spending, according to this children's hospital CEO.
Editor's note: R. Lawrence Moss, MD is the president & CEO of Nemours Children’s Health, based in Jacksonville, Florida.
Recently, I sat with a peer group of CEOs of some of the largest and best medical centers in the country. The topic at hand was the impending massive cost of weight loss drugs (GLP-1 agonists) and how we as a healthcare system and a society were going to pay for these drugs. Thoughtful estimates of potential costs exceeded tens of billions of dollars and only went up from there.
As a children’s hospital CEO, I had empathy for my adult colleagues who deal every day with a massive burden of chronic disease. They are charged with supplying expensive, complex therapies that can only slightly mitigate the inexorable progression of the four major killers in the US: diabetes, heart disease, cancer, and Alzheimer’s.
I made the comment, which fizzled like a wet firecracker, that if we spent a tiny fraction of that sum on early childhood education, we could reduce the incidence of obesity far more effectively than even the greatest wonder drug. As our government seeks to trim spending and find cost efficiencies, the prevention of chronic disease in adults would be the ultimate cost saver, dramatically lowering our spending on Medicare and Medicaid while increasing worker productivity.
On the way home, I read a recent study in the journal Science finding that children conceived and born in Britain at a time of sugar rationing during World War II grew up to have a markedly lower incidence of diabetes and high blood pressure than children born shortly after rationing was lifted.
This juxtaposition of events was a perfect example of what is wrong with healthcare in America. We address every problem in health, even those whose causes are non-medical social drivers of health, by throwing expensive medical care at it. The U.S. has a rate of obesity that is by far the highest among our peer nations. This is not because we are genetically different than our overseas friends. It is not because we have contracted an infection that causes chronic disease. It is because the American lifestyle has caused rampant obesity. Rather than even consider changing the American lifestyle, we have invented expensive new drugs to combat obesity with medical care rather than prevention.
We have known for decades that small, inexpensive interventions in children can have a massive impact on adult health. In the mid-1970s, the Abecedarian Project, led by Nobel Prize winner James Heckman, provided high-quality childcare to two groups of kids from birth to age five, emphasizing language, conversation, and learning games. They added nutritional education and a healthy snack in one group. It then followed these children for decades. In their 30s, the group that had the nutrition intervention had markedly lower rates of hypertension than their peers, were less obese, and not a single one had metabolic syndrome, which often leads to heart disease, stroke, and diabetes. It also improved their employment status, their income, and reduced criminal activity among male participants. Heckman’s later work found there were even multigenerational positive health effects on the participants’ children.
Society would reap the benefits in a healthier, longer-living workforce. But it’s important to note who would lose: processed food companies that keep people coming back with added sugar and fat; hospital systems that—in fee-for-service America—are designed to profit from treating illness; and pharmaceutical companies that make money by treating chronic disease. Are we willing to make the simple, inexpensive changes in childhood that make Americans healthier and save money in the process, or are we simply too accustomed to profiting from illness?
Our system is not incentivized to behave this way, nor to spend its money this way. Only 7% of healthcare dollars in this country are spent on children, and forms of social spending directed toward child health or long-term human health are not seen as a form of healthcare.
We must address non-medical threats to health with direct interventions that address the root causes, not with expensive high-tech medical care once the disease is established. Investing in child health is the single most powerful lever we have to create the healthiest generations of Americans and the most robust economy. We must summon the will to pull it.
Editor's note: Care to share your view? HealthLeaders accepts original thought leadership articles from healthcare industry leaders in active executive roles at payer and provider organizations. These may include case studies, research, and guest editorials. We neither accept payment nor offer compensation for contributed content.
Having a virtual nurse available during discharges eliminates distractions, says this CNE.
On this episode of HL Shorts, we hear from Catherine Hughes, senior vice president and chief nurse executive of Virtua Health, about the concrete benefits that Virtua Health has seen from their virtual nursing program. Tune in to hear her insights.
Nurse leaders are gathering in Boston this year to strategize best practices for AI, virtual nursing, and how to streamline care models with technology.
As technology continues to embed itself into every industry, healthcare is bracing for the impact that AI will have on everything.
From the C-suite down to the bedside, AI and other new technologies will soon become care staples that nurses and patients alike will need to become familiar with. However, there is a right way and a wrong way for leaders to implement these changes.
That's why thousands of nurse leaders are coming together in Boston from March 30 to April 2 to brainstorm at the AONL 2025 Aspiring Leaders conference.
What to watch
The conference consists of daily sessions where various nurse leaders will highlight industry trends and provide their high-level insights to their peers. Generative AI and its pros and cons will be a hot button issue, as well as digital transformation strategies and the role of virtual nursing in care delivery.
Leadership development, specifically for nurse managers, is also top of mind as CNOs and CNEs engage in succession planning. In the fall 2024 Trends and Innovations Nurse Manager Retention report published by AONL and Laudio, nurse managers had four priorities that they want CNOs and other nurse leaders to focus on: ensuring a healthy work environment, promoting leadership development, identifying new leaders early, and addressing role complexity. These priorities and more will be central to the discussions in Boston.
Last but not least, workplace violence continues to be a large trend as incidents continue to rise and nurses keep bringing the issue to light. CNOs and other nurse leaders must keep working on prevention efforts while also streamlining the processes for reporting and following up on incidents when they occur.
As this year's AONL attendees come up with strategies for these issues, HealthLeaders will be there to take note of what is and isn't working.
Other sessions will cover policy and advocacy, transition to practice, and how to create a more diverse, stable workforce that values mental health and wellness. Attendees will have the opportunity to attend these sessions as well as walk through the exhibit hall.
A new report says healthcare organizations are finding value in using ambient AI to reduce burnout and stress, but financial value is harder to assess
Ambient AI scribes may be all the rage in healthcare these days, with more than 60 different products on the market. But are they showing ROI?
A new report from the Peterson Health Technology Institute (PHTI) says AI scribes “are poised to become one of the fastest technology adoptions in healthcare history.” But as a task force convened by PHTI learned, healthcare executives may be rushing to implement these tools before determining their value.
The challenge, as always, comes in the definition of value. Many healthcare leaders who are using AI scribes report success in reducing physician stress and burnout, a key metric in today’s healthcare environment. Yet with health systems and hospitals struggling to contain costs, there’s a financial aspect to technology implementations that has yet to be realized with scribes.
According to the PHTI report, the task force launched with a question: Can a new generation of AI solutions that target administrative tasks and day-to-day workflow improvements address the previously intractable tension between increasing productivity and reducing provider burnout?
The answer is, well, complicated.
“Ambient scribes appear to reduce burnout and cognitive load and improve the patient experience,” the report stated. “The current evidence for ambient scribe improving productivity directly by reducing documentation time is mixed, though as the technology and implementation processes improve, time savings may become more apparent. Given the costs and limited evidence to date on ROI, however, there is a real risk that as ambient scribe adoption continues apace, health systems will implement solutions in ways that add to overall costs of care.”
The task force noted that healthcare technology market has often evolved faster than the effort to produce meaningful results, and this is certainly true in AI. Healthcare providers are jumping on the bandwagon and piloting new tools and services well before they have a good idea about ROI—or, in many cases, governance.
This experience is also causing healthcare leaders to step back and assess what value means to them. Faced with a declining workforce and pressures to reduce workflows to keep the people they have, some executives are pointing out that a tool that can improve a clinician’s work-life balance and reduce stress does produce positive ROI, and financial savings will show up in reduced turnover and hiring and training costs, not to mention morale. And that, in turn, will positively affect clinical outcomes.
But that will take time. And that seems to be the one factor that many overlook.
“There are many other areas of health system administration ripe for transformation with AI-enabled technologies,” the task force concluded. “AI in RCM is likely to be the next significant area of at-scale solution deployment, and task force members anticipate significant progress in AI for call centers, quality and regulatory reporting, inbox management, and CDS in the coming years. “
“The promise of AI in each of these areas is compelling but the ability to deliver on that promise will take time, enhanced technological sophistication, and organizational maturation,” the report said. “The experiences of early adopters can inform the broader industry on whether the investment in these technologies is warranted, how to measure impact and track progress, and which technologies are delivering outsized returns.”
Here are three tools that nurses and nurse leaders can use to prioritize their wellbeing.
Focusing on wellbeing is critical for nurse leaders who want to combat burnout and lower nurse turnover rates.
For CNOs who want to prioritize wellbeing and self-leadership for their workforces, Diane Sieg, a registered nurse, author, and the creator of the Well-Being Coaching Initiative, suggested "CPR," but not in the traditional sense of the term.
"CPR stands for compassion, presence, and recovery," Sieg said. "It's not the CPR that nurses are familiar with, but [it's] just as lifesaving because it infuses more energy, more engagement, [and] more connection into your work and life."
CNOs must look at metrics that will help them leverage virtual nursing through the future and continue to improve the experience for nurses and patients.
On this episode of HL Shorts, we hear from Jennie Van Antwerp, director of digital acute care at OSF OnCall, about the ROI metrics CNOs can use to make a financial case for virtual nursing. Tune in to hear her insights.
