Clinical informatics leaders expect 2026 to bring accelerating demands, tightening resources and an AI landscape evolving faster than governance and frontline workflows can absorb. Among CMIOs and CNIOs, the consensus is clear: Transformation is outpacing the structures meant to support it.
Here are seven insights on what’s ahead.
1. AI is expanding faster than adoption, governance and workforce readiness
AI will shape nearly every facet of care delivery in 2026 — but informatics leaders say the headwinds are not technical. They’re structural.
- Maggie Cunningham, DNP, CNIO of Fairfax, Va.-based Inova, said AI will fundamentally change how teams “care, educate, schedule and communicate,” but organizations must do significant work to prepare teams and build trust around risk.
- Dipti Amin, MD, CMIO of St. Petersburg, Fla.-based Johns Hopkins All Children’s Hospital, said health systems are being inundated with AI solutions, making it difficult to identify which tools will deliver meaningful value amid financial constraints.
- Usman Akhtar, MD, CMIO of Arlington, Va.-based Virginia Hospital Center, described the collision of “AI everywhere” and immature governance, noting informatics is expected to support embedded and shadow tools they don’t fully control.
- Jason La Marca, MD, CMIO of Los Angeles-based Mission Community Hospital, emphasized the need for strong guardrails around AI ethics, bias monitoring, data quality and model validation to avoid replacing clinical judgment with speed alone.
- Becket Mahnke, MD, CMIO of Wenatchee, Wash.-based Confluence Health, said the true barrier will be clinician adoption; uneven use of AI could widen practice variation and fracture the patient experience.
- Amer Saati, MD, CMIO of Roseville, Calif.-based Adventist Health, said rapid adoption must be balanced with governance, safety and equity to maintain clinician trust.
- Neal Chawla, MD, CMIO of Raleigh, N.C.-based WakeMed, said AI must be deployed while still balancing technical debt and application rationalization — creating tension between innovation and foundational upkeep.
Among leaders, the message is consistent: AI introduces opportunity, but without governance, adoption, interoperability and workforce readiness, its impact will be limited.
2. Informatics responsibilities are expanding faster than the role is understood
Multiple leaders said role ambiguity is becoming a headwind as digital transformation accelerates.
- Marc Benoy, RN, CNIO of Akron, Ohio-based Summa Health, said informatics is still too often viewed as “nursing work” or “EHR optimization” rather than an enterprise discipline touching operations, quality, safety, workforce experience and transformation.
- Dr. Akhtar described unclear authority for informatics teams as a structural barrier, especially as AI tools surface across the enterprise without coordinated ownership.
- Dr. Saati said interoperability expectations and digital initiatives are accelerating faster than the resources allocated to informatics, compounding the mismatch between scope and support.
As boundaries between clinical practice, analytics, IT and operations blur, leaders said informaticists must continually clarify what their teams do — and what they don’t — to avoid being stretched to unsustainable levels.
3. Demand for informatics work is rising faster than teams can support
The volume, velocity and complexity of requests continue to increase across health systems.
- Mr. Benoy said rapid-cycle design, build, testing and deployment often outpace operational readiness and governance, pulling informatics teams into workflow redesign, policy updates and staffing model changes without added resources.
- Dr. Akhtar said informatics is often expected to deliver results in environments where data quality, system fragmentation and governance gaps persist.
The result: Teams are taking on more work across more domains, with higher expectations and no proportional expansion in capacity.
4. Financial pressure and labor shortages are slowing digital transformation
Leaders pointed to tightening budgets and shrinking workforces as significant barriers.
- Marc Perkins-Carrillo, MSN, RN, CNIO of Tampa, Fla.-based Moffitt Cancer Center, said informatics is still misperceived as a cost center, which leads to under-resourcing even though informatics enables efficiency and long-term savings.
- Dr. La Marca noted that community hospitals with government-heavy payer mixes face particularly steep headwinds as margins narrow.
- Joseph Evans, MD, chief health information officer of Norfolk, Va.-based Sentara Health, said Affordable Care Act and Medicaid reimbursement shifts will intensify the fiscal challenge but may also force systems to innovate in more targeted, high-value ways.
- Jared Houck, RN, CNIO of Charleston, S.C.-based Roper St. Francis Healthcare, said organizations often undervalue AI and informatics because the gains are incremental, yet these improvements compound to protect workforce capacity and operational stability. Financial models still favor “step-function” returns like immediate FTE or cost reductions, he said, which can lead to underinvestment in the usability, reliability and trust that sustain transformation.
Meanwhile, competition from vendors and industry continues to squeeze the pipeline of hybrid clinical-technical talent.
5. Clinician bandwidth for engagement continues to erode
Multiple leaders noted the gap between transformation goals and frontline capacity.
- Mr. Benoy said clinicians are so stretched that participation in discovery, validation, training and change management is increasingly limited, leaving informatics teams to shoulder more of the work.
- Dr. Mahnke linked this bandwidth issue to AI adoption: Without consistent clinician engagement, AI becomes optional rather than standard work — deepening variation and slowing progress.
The strain on clinicians has become a structural barrier to digital transformation.
6. Interoperability demands, technical debt and cybersecurity risk remain foundational challenges
Leaders stressed that while AI is driving excitement, longstanding infrastructure issues remain unresolved.
- Dr. Saati said interoperability expectations are rising faster than the workforce and resources needed to support them.
- Dr. Chawla underscored the complexity of balancing innovation with technical debt and application rationalization.
- Dr. La Marca said cybersecurity is a growing pressure point as threats evolve, requiring heavy investment in network protections, monitoring and staff education.
These foundational issues limit how quickly, and safely, emerging technologies can be scaled.
7. Cross-functional collaboration is essential — but governance is still maturing
Informatics sits at the center of nursing, medicine, IT, analytics, finance, HR, quality and operations — and leaders said this dependency will only increase.
- Mr. Benoy said unified governance structures are not keeping pace with cross-functional demands, leaving informatics to mediate between siloed teams without increased authority or resources.
- Dr. Akhtar noted a similar friction, saying unresolved structural issues make sustainable transformation far more complex than “turning on AI.”
Without stronger, shared governance, informatics teams risk absorbing organizational strain without sufficient support.
