Field Notes Newsletter #4 - August 2026
- Keith Washington
- Aug 5
- 8 min read
Technology Isn't the Strategy Anymore
Walk through any healthcare conference today and you'll hear familiar conversations about artificial intelligence, interoperability, ambient documentation, digital transformation, and the next generation of electronic health records. Every session promises smarter technology, faster workflows, or better data.
But beneath all of those conversations, something more fundamental is happening. That observation was reinforced at the recent 2026 Physician-Computer Connection (PCC) Symposium hosted by the Association of Medical Directors of Information Systems (AMDIS). Reviewing presentations from CMIOs and healthcare informatics leaders across topics ranging from AI and EHR strategy to governance, clinician inbox management, training, interoperability, and revenue cycle, a clear pattern emerged. Regardless of the topic, the discussion consistently returned to one central idea: technology alone isn't enough. Success depends on thoughtfully designing the systems, workflows, and governance that enable technology to improve care. Readers can explore the full collection of presentations on the AMDIS 2026 PCC Symposium Presentations page.
We see that healthcare's focus is quietly shifting away from technology itself and toward something much more important: how we design systems that help people do their best work.
That's a significant change.
For years, healthcare technology conversations revolved around implementation. Which EHR should we buy? Which AI tool should we adopt? Which platform has the most features? Success was often measured by whether a project was completed on time and on budget.
Today, those questions are becoming secondary.
The more important questions are:
How does this fit into the clinician's workflow?
Does it reduce cognitive burden or add to it?
Does it help teams make better decisions?
Does it improve the patient experience?
Can it scale across the organization?
Who owns it after implementation?
These aren't technology questions. They're design questions.
That's encouraging because technology, by itself, has never been the hard part.
Healthcare has no shortage of innovation. Every year brings more capable AI models, more sophisticated analytics, better interoperability standards, and increasingly intelligent clinical tools. Yet despite these advances, many organizations still struggle with clinician burnout, fragmented workflows, alert fatigue, communication gaps, and inconsistent adoption.
The problem isn't that healthcare lacks technology. The challenge is that technology alone doesn't create transformation – design does.
From Buying Solutions to Building Systems
One of the biggest mindset shifts occurring across healthcare is recognizing that success isn't determined during procurement. It's determined long after implementation.
Organizations spend months evaluating vendors, comparing features, negotiating contracts, and conducting demonstrations. Those activities matter, but they're only the beginning.
The organizations seeing the greatest value are asking different questions. Instead of focusing exclusively on what the technology can do, they're asking how people will actually use it. They're redesigning workflows, engaging frontline clinicians early, measuring outcomes that matter, and continuously refining the experience after go-live.
In other words, they're treating technology as one component of a larger system rather than the system itself. This reflects a broader shift toward systems thinking. Rather than optimizing individual technologies in isolation, leading organizations are recognizing that people, workflows, governance, data, and technology function as an interconnected system. Improving one component without understanding the relationships among all of them rarely produces lasting results.
That's the difference between implementation and transformation.
AI Doesn't Change This—It Reinforces It
Artificial intelligence has accelerated this shift.
The conversation is no longer about whether AI belongs in healthcare.
That debate is largely behind us. Now the questions are far more practical.
How do we govern AI responsibly?
Where does it create meaningful value?
When should humans remain firmly in control?
How do we integrate AI into existing workflows without introducing new complexity?
Notice that none of these questions begin with the technology. They begin with people.
The most successful AI initiatives won't necessarily come from organizations using the most sophisticated algorithms. They'll come from organizations that thoughtfully integrate AI into clinical workflows, preserve trust, and improve decision-making without increasing cognitive load.
Technology succeeds when it complements human expertise, not when it competes with it.
Leadership Looks Different Now
This shift also changes what leadership looks like.
Healthcare leaders are no longer expected to simply oversee implementations. Increasingly, they're responsible for connecting technology strategy with operational strategy, clinical strategy, and organizational culture.
That requires a different set of skills.
Listening becomes as important as selecting vendors.
Governance becomes as important as innovation.
Workflow design becomes as important as software configuration.
Success depends less on managing projects and more on bringing clinicians, operational leaders, IT teams, and vendors together around shared outcomes.
The best technology decisions are rarely made by technology alone.
Designing for the People Who Deliver Care
At Beyond the Blueprint, we've had the privilege of speaking with healthcare leaders who consistently return to one central idea: better outcomes begin with better design.
Whether we're discussing workforce challenges, leadership, AI, nursing, physician education, or innovation, the underlying principle remains remarkably consistent.
Design the experience before you deploy the technology.
Understand the workflow before you automate it.
Build with clinicians instead of for clinicians.
Measure success by outcomes rather than features.
Those principles aren't new.
What's changing is that healthcare is finally beginning to embrace them at scale.
Technology will continue to evolve. AI capabilities will improve. New platforms will emerge. Regulations will change. Innovation will accelerate.
But none of those advances will matter unless they're connected to thoughtful system design.
Technology isn't the strategy anymore. That's why one of the strongest takeaways from this year's AMDIS PCC Symposium wasn't a breakthrough technology announcement or a bold AI prediction. It was the remarkable consistency of the conversations. Whether discussing AI governance, clinician burnout, EHR optimization, interoperability, physician leadership, or informatics strategy, speakers repeatedly emphasized the same principle: better outcomes come from designing better systems, not simply deploying more technology.
It's an enabler of strategy.
The organizations that thrive over the next decade won't necessarily be those with the newest tools. They'll be the ones that intentionally design systems where technology, workflows, governance, and people work together to make care better for clinicians, patients, and the organizations that serve them.
That's a future worth designing.
From the Field
Notable conversations you need to hear
EP51 - AMDIS Roundtable - The AI Decisions Missing From the Medical Record
AI is already influencing clinical decision-making, but what happens when those decisions occur outside the systems hospitals can monitor?
In this AMDIS Roundtable, Gregg Malkary is joined by Dr. John Lee, Dr. Paul Sutton, and Dr. Stephon Proctor to examine the growing use of consumer AI tools like ChatGPT, Claude, and Gemini at the point of care. As physicians increasingly turn to these tools for clinical questions, documentation, differential diagnoses, and workflow support, health systems are facing a new challenge: understanding how AI is shaping care when those interactions never appear in the medical record.
The discussion explores where clinicians find value in consumer AI, the risks of shadow AI, and why governance can't focus solely on restricting access. Instead, the panel examines how health systems can build trusted, enterprise-ready AI tools that fit naturally into clinical workflows while protecting patient privacy, preserving clinical judgment, and supporting better care.
Whether you're a CMIO, informatics leader, physician executive, or healthcare technology strategist, this conversation offers practical insight into one of the most important—and least visible—AI challenges facing healthcare today.
Sound Bites
The moments that made us hit rewind
EP52 - Acting Before the Patient Deteriorates: Enterprise Clinical Surveillance and the Internet of Medical Things (IOMT)
Every monitor in a hospital is good at its job.
A bedside monitor understands physiologic signals. An infusion pump knows medication delivery. The EHR tracks documentation. Each system generates valuable data, but each sees only one part of the patient's story. As Matt Grubis observes, "maybe it's actually not information yet."
Meanwhile, nurses are doing what they've always done: connecting those pieces in their heads while moving from room to room, responding to alarms, administering medications, and constantly deciding who needs them first.
For the Chief Clinical Informatics Officer, success is measured after the alert fires. Did it reach the right clinician? Did it fit into their workflow? Was it trusted? Did someone take ownership, and did the right action follow? Those are the questions that separate technology that helps clinicians from technology that becomes one more interruption in an already demanding shift.
In this episode of Beyond the Blueprint, host Gregg Malkary is joined by:
Jason Atkins, Vice President & Chief Clinical Informatics Officer, Emory Healthcare
Matt Grubis, Chief Engineer, Monitoring Solutions, GE HealthCare
Ryan Fox, Digital & IoMT Strategy Lead, GE HealthCare
Together, they explore how the Internet of Medical Things (IoMT) is helping health systems connect isolated streams of clinical data into a fuller picture of the patient. Matt illustrates the idea with a simple analogy: a thermostat that knows not just the room temperature, but also the position of the sun. The conversation covers enterprise clinical surveillance, where AI fits when it disagrees with a clinician's bedside judgment, and why "human in the loop" isn't going away anytime soon. It also explores what real vendor partnership looks like when there's actual skin in the game for clinical adoption instead of another tool handed off for the hospital to implement.
Because everyone shares the same goal: helping care teams recognize what matters, coordinate their response, and act before a patient's condition deteriorates.
Sound Bites
The moments that made us hit rewind
Footnotes
Further reading for curious minds
Every great conversation leaves you with something to explore. Footnotes is where we collect the books, articles, research, podcasts, and other resources mentioned or recommended by our guests, along with a few additional references that add context to the ideas discussed. Think of it as a curated reading list for anyone who wants to dig a little deeper. You're welcome!
Further reading:
A new Wolters Kluwer survey found that unauthorized "shadow AI" tools are already being used across U.S. hospitals, including for direct patient care, highlighting an urgent need for stronger AI governance, enterprise-ready solutions, and clear policies to balance innovation with patient safety, privacy, and regulatory compliance.
The Space Between Intention and Experience - Beyond the Blueprint guest Elizabeth Jeanes (Episodes 48 and 49) recently expanded on one of the key themes from her podcast conversations in a thoughtful LinkedIn article, "The Space Between Intention and Experience." Elizabeth explores a challenge every healthcare leader faces: the gap between what leaders intend and what their teams actually experience. Good intentions alone don't create trust, engagement, or healthy workplace cultures. Instead, leaders must actively seek feedback, remain curious, and be willing to adapt when their actions don't have the desired impact. It's a timely reminder that the strongest cultures are built through consistent leadership behaviors, not intentions, and that closing this gap is essential to creating environments where caregivers and patients can thrive.
From Podcast to Prototype: BTB Guest Builds AI for the Front Lines of Care - Beyond the Blueprint guest Dr. Stephon Proctor (Episode 51) recently put many of the ideas discussed on the podcast into practice at the Abridge Hackathon in San Francisco. Teaming up with fellow BTB guest Dr. John Lee, the pair joined 150 innovators challenged to build an AI solution that healthcare teams could begin using immediately. Their prototype, a clinical copilot designed to surface the most relevant information from lengthy, fragmented patient records, addressed one of healthcare's biggest challenges: helping clinicians find critical information quickly when every second counts. The project reinforces a recurring theme from Beyond the Blueprint: the most valuable AI isn't built in isolation. It's developed with clinicians, for clinicians, to fit naturally into real-world workflows.
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