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.

• Why physicians are turning to consumer AI tools during clinical care
• The operational and governance risks of shadow AI
• Privacy concerns when protected health information enters public AI platforms
• Where enterprise AI solutions still fall short of clinician needs
• Balancing clinician autonomy with organizational oversight
• How AI may reshape documentation, decision support, and clinical workflows
• Why transparency—not prohibition—will be essential for responsible AI adoption

00:00 | Shadow AI Is Already at the Point of Care
03:12 | How Physicians Are Using Consumer AI Behind the Scenes
07:08 | Why ChatGPT Feels Different Than Traditional Medical References
11:18 | OpenEvidence, MedPearl, and AI at the Bedside
15:46 | Real-World Uses for AI in Emergency Medicine
21:04 | Why Chart Summarization May Be AI's Biggest Win
24:07 | Inside Epic's New Agent Factory
28:42 | The Promise—and Risk—of Agentic AI
34:18 | Why Data Governance Must Come Before AI
38:11 | Ambient AI, Chart Summaries, and the Lowest-Hanging Fruit
40:58 | Hallucinations, Clinical Judgment, and the Human in the Loop
43:02 | Are We De-Skilling the Next Generation of Physicians?
45:34 | How Do We Replace Shadow AI with Trusted Enterprise Tools?
47:49 | Final Advice for Healthcare Informatics Leaders

Guests: Dr. John Lee, Dr. Paul Sutton, and Dr. Stephon Proctor
Host: Gregg Malkary - Lighthouse Healthtech
Sponsored by: Simplifi Medical
Audio/Video: Tim Jones - Health Nuts Media
Marketing: Josh Troop - Troop-Creative
Learn More at: www.beyond-blueprint.com

AI can identify a patient at risk. But what happens when the nurse receiving the alert is already caring for another patient?

As hospitals continue adopting AI-powered clinical decision support tools, nursing leaders face a practical challenge: identifying risk is only part of the equation. Acting on it requires people, workflows, communication, and clinical judgment.

In this episode of Beyond the Blueprint, Gregg Malkary is joined by Daniel Gracie, Carolyn S. Harmon, and Troy Seagondollar to explore how AI-driven alerts intersect with the realities of nursing practice. The conversation examines alert fatigue, cognitive overload, accountability, workflow design, and the limits of technology when resources and staffing remain constrained.

The discussion also explores why AI should support -- not replace -- clinical judgment, how poorly designed workflows can undermine even the most advanced tools, and what healthcare organizations should consider before introducing new AI-driven alerts into patient care environments.

Whether you're a nursing leader, informatics professional, healthcare executive, or technology innovator, this conversation offers a grounded look at what it takes to translate AI insights into meaningful action at the bedside.

• AI can identify risk, but it can't create capacity
• Clinical decision support is not clinical decision making
• Alert fatigue remains a significant patient safety challenge
• The right alert at the wrong time may not change care
• Experience still matters when prioritizing patient needs
• Technology can't fix broken workflows
• Escalation pathways matter as much as the alert itself
• Frontline nurses should help design AI-enabled workflows
• Better data leads to better clinical decision support
• AI should augment clinical judgment, not replace it

00:00 | AI Alerts Are Decision Support Tools, Not Decision Makers
04:29 | When a Nurse Can't Respond to an Alert Right Away
06:09 | Why the Same Alert Means Different Things to Different Nurses
07:40 | Alert Fatigue, Cognitive Load, and Patient Safety
11:15 | What Happens When a Nurse Leaves One Patient to Respond to Another
14:12 | "Treat the Patient, Not the Alert"
16:04 | Do We Need Air Traffic Control for Clinical Alerts?
16:26 | Why AI Can't Fix Poor Workflow Design
18:25 | AI as Decision Support, Not Decision Making
20:30 | Lessons from Telemetry Monitoring and Alarm Fatigue
21:57 | Who Is Accountable When an Alert Is Missed?
23:07 | Why Technology Can't Fix Broken Processes
24:12 | The Cost of Automating Bad Workflows
28:16 | Can AI Be Personalized for Different Clinical Environments?
29:51 | Why Data Quality Determines AI Performance
30:32 | Translating AI Research into Clinical Practice
32:23 | What Nursing Leaders Should Do Before Implementing New AI Tools

Guests: Daniel Gracie, Carolyn S. Harmon, Troy Seagondollar
Host: Gregg Malkary - Lighthouse Healthtech
Sponsored by: Simplifi Medical
Audio/Video: Tim Jones - Health Nuts Media
Marketing: Josh Troop - Troop-Creative
Learn More at: www.beyond-blueprint.com

Healthcare leaders often talk about culture, engagement, and retention. But what if many workforce challenges aren't simply staffing problems at all?

In this episode of Beyond the Blueprint, host Kris Baird and co-host Keith Washington welcome nurse leader and workforce strategist Elizabeth Jeanes for a conversation about the connection between leadership, culture, and workforce design.

Drawing on years of experience in nursing leadership and organizational development, Elizabeth explores why culture isn't built through mission statements or posters on a wall—it's built through consistent leadership behaviors, accountability, and the daily decisions leaders make about what they tolerate and what they reinforce.

Together, they discuss leadership burnout, generational differences in the workforce, the importance of purpose-driven leadership, and the difficult reality of managing toxic high performers. The conversation also examines how healthcare organizations can create environments where caregivers feel valued, connected, and supported—and why those efforts ultimately impact both retention and patient care.

Whether you're a nurse leader, executive, frontline manager, or healthcare innovator, this episode offers practical insights into building cultures where both caregivers and patients can thrive.

• Culture is shaped by leadership behaviors, not mission statements.
• Organizations often achieve the results their systems are designed to produce.
• Leadership development is essential for workforce stability and retention.
• Toxic high performers can cause significant damage to team culture.
• Gen Z caregivers place a high value on culture, belonging, and trust.
• Strong leaders help teams stay connected to purpose and meaning.
• Leadership burnout is an often-overlooked challenge in healthcare.
• Psychological safety requires active leadership and accountability.
• Technology should help caregivers spend more time with patients, not less.
• Positive culture change often begins with influential frontline team members.

00:00 | Toxic Superstars and What Leaders Tolerate

03:30 | Culture by Design vs. Culture by Default

04:35 | Why Leadership Behaviors Shape Organizational Culture

06:09 | Promoting Great Clinicians Doesn't Automatically Create Great Leaders

09:52 | Helping Leaders and Teams Reconnect to Purpose

11:25 | The Hidden Cost of Leadership Burnout

13:16 | Why Gen Z Views Leadership and Workplace Culture Differently

17:13 | Building Psychological Safety in Healthcare Teams

18:05 | The Difficult Decision: Keeping or Losing a Toxic High Performer

22:17 | Bringing Purpose Into Everyday Leadership

25:05 | Seeing Patients as People, Not Room Numbers

26:16 | How Technology Can Help Nurses Return to the Bedside

28:53 | What Every Generation Wants from Leaders

30:06 | Finding the Culture Champions Already Inside Your Organization

Guest: Elizabeth Jeanes - Jeanes Strategic Consulting

Host: Kristin Baird - Baird Group
Co-host: Keith Washington - Companions in Courage Foundation
Sponsored by: Simplifi Medical
Audio/Video: Tim Jones - Health Nuts Media
Marketing: Josh Troop - Troop-Creative
Learn More at: www.beyond-blueprint.com