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Academy 360 | AI-Catalyst

Session Breakdown | Chief Information Officer Forum

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CIO leaders came together at THMA’s CIO Forum to discuss the headwinds and tailwinds impacting their IT strategy. A few key themes emerged:

1. Most CIOs operate within fragmented, reactive structures while striving to establish more proactive and centralized oversight in their systems.

  • Pervasive shadow AI creates governance gaps: CIOs reported widespread, unauthorized use of generative tools and ambient documentation AI—often deployed by well-intentioned individuals (e.g., physicians or researchers) who don’t fully understand risk.

  • While many health systems have AI committees, only a minority have formal enforceable policies in place: One leader crafted policy with a legal team but struggled to convince others of its necessity.

  • Attempts to create structure are accelerating AI oversight committees and Centers of Excellence (COEs) are forming to consolidate review.

2. Contracting Scrutiny Around AI is Tightening

  • Smaller approval loops encouraged: One leader emphasized reducing contract approval authority to a “super small group” to centralize control and mitigate the risk of rogue procurement.

  • Ambient and embedded AI make oversight difficult: Tools with hidden AI components complicate governance. One CIO mentioned reviewing every contract, even for appliances, if AI is involved.

  • Frameworks from external organizations were a helpful guidepost for executives in developing their organization’s policy approach.

3. IT Cost Pressures Are Peaking—But So Is Strategic Framing

  • IT as investment, not overhead: CIOs are shifting focus to IT as a strategic investment, emphasizing ROI and shared accountability. They are working to build cultural alignment around this shift—using tools like portfolio reviews and ROI dashboards.

  • Traditional cost-cutting strategies are tapped out (e.g., app rationalization, outsourcing). Multiple CIOs lamented being “out of levers.”

4. Benchmarking Remains Elusive but Desirable

  • Demand for peer-shared tools is high: Leaders repeatedly voiced interest in AI governance templates, policy examples, and documentation protocols.

  • Meaningful comparison is hindered by inconsistent accounting and organizational structures.: CIOs felt that no benchmarking survey could be truly accurate due to wildly different cost attribution methods across systems.

  • Discussions and storytelling often better tools than traditional benchmarking . Epic noted for delivering benchmarks and actionable insights that help leaders tell a compelling ROI story.

5. AI Literacy is a Top Priority

  • Education is a critical bridge to mitigating risk gaps.

  • Many praised THMA’s AI Catalyst bootcamp for improving operator literacy.

So What?

With AI rapidly infiltrating clinical and non-clinical workflows, and traditional IT cost levers largely exhausted, CIOs are being pushed to both safeguard the enterprise and unlock new forms of value. Gaps in governance, unclear ROI accountability, and cultural inertia around IT as a “cost center” risk slowing progress—or introducing avoidable risk. Addressing these issues isn’t just an IT concern; it’s central to improving system-wide efficiency, resilience, and patient safety.