Doing Well and Doing Good: Five Design Imperatives for Health Systems in an Era of AI Transformation

Additional authors include Philip Payne, Ph.D., FACMI, Chief Health AI Officer, WashU Medicine and BJC Health; Thomas Kannampallil, Ph.D., FACMI, FAMIA, Chief Data Scientist, WashU Medicine; Albert Lai, Ph.D., FACMI, FAMIA, Chief Research Information Officer, WashU Medicine; Cynthia Marich, M.Litt., Chief of Staff, Center for Health AI, WashU Medicine; Jared Esker, PMP, CSM, Senior Director, Agile Operations, Center for Health AI, WashU Medicine; Andrea Krussell, M.A., Director, AI Education and Workforce Development, WashU Medicine.

The paper was informed by the generous input of organizations in the Digital Health and AI Learning Collaborative, a peer community of leaders from 24 academic medical centers. For information on how to join, please contact or .

Manatt Health, in collaboration with the AAMC, convened the Digital Health and AI Learning Collaborative for its fifth year in 2026. This spring, the Collaborative met at WashU Medicine and BJC Health’s Center for Health AI (CHAI) to explore a critical question: how can health systems leverage AI and digital health to both strengthen organizational performance and improve health in the communities they serve?

Below is an edited excerpt from the brief summarizing key takeaways from the retreat. Click to download the full report, case studies and examples.

Health systems today face multiple competing pressures. On the one hand, they must improve financial sustainability, operational performance and workforce efficiency despite the ongoing economic and workforce challenges. On the other hand, they are expected to expand access, improve patient outcomes and mitigate disparities in care.

The rapid evolution of AI and digital health technologies presents an opportunity to address these challenges in new ways. Rather than relying solely on traditional brick-and-mortar approaches, health systems can use digital and AI capabilities to extend their reach and make care more accessible. Yet resources to invest in these technologies remain limited and leaders must make difficult choices about where to focus efforts.

Participants identified five design choices that can help health systems improve performance while expanding their impact, offering a framework for organizations seeking to maximize both organizational value and community benefit.

1. Prioritize Digital and AI Investments with Strategic Discipline: By aligning digital and AI investments with enterprise strategy and community needs, health systems direct limited resources toward initiatives most likely to improve performance, workforce experience and patient care.
2. Adapt Governance to the Pace of Change and Level of Risk: As interest in AI grows, traditional IT governance models and AI committees have difficulty keeping pace.
3. Adapt Evidence and Measurement Approaches to AI: The evolving nature of AI tools requires a different approach to evaluation and measurement than traditional clinical technologies. 
4. Equip the Workforce for AI-Enabled Operations: Attaining value from AI requires more than deploying AI tools. Health systems must prepare clinicians and staff to use AI effectively and change how they work.
5. Leverage Digital and AI Capabilities to Build Care and Operational Models That Expand Capacity and Reach: Health systems are using digital and AI capabilities to redesign where care is delivered, how patients access and engage with services and how clinical teams deploy limited capacity.

Together, these imperatives can help health systems deploy digital and AI capabilities to drive organizational performance as well as meaningful impact for the patients and communities they serve.

Click for the full report.