HFMA found
that 75 percent of health systems
have adopted clinical AI.
18 percent
have formal governance in place.
Every week
I sit across from a CMO,
a CFO, a board member.
The gap between those two numbers
is in the room with us.
Here is what it sounds like.
We have a three year AI roadmap.
We have pilots running.
Our teams use AI daily.
We are looking into it.
Dig past those lines
and the confidence goes quiet.
The roadmap was written by someone else.
The vendors had agendas.
The peers in every other room
were performing the same confidence.
No one had the room to say it out loud.
I do not know enough to challenge this.
The cost of that silence
reaches past the boardroom.
A deployment that harms a patient.
A renewal that surfaces coverage
nobody named.
A board that approved accountability
nobody owned.
The executives who actually understand
what clinical AI can do,
not the vendor pitch, the real capability,
walk in with three questions
nobody prepared for.
↳ What is this roadmap actually based on?
↳ What specific problem does it solve?
↳ What value will it produce, and how will we measure it?
When the room goes quiet on those three,
the governance gap
has just introduced itself.
You have sat in that room.
You already know
what happens when those three get asked.
Mo Johnson, MD MBA is a cardiothoracic surgeon and the founder of GPe Research. Field Notes are short dispatches from the clinical AI accountability frontier, published alongside the MedicoVigilance™ newsletter at medicovigilance.org.
Follow the work on LinkedIn: linkedin.com/in/mo-johnson