“One of the challenges is avoiding what we call ‘pilot-itis,’ where organizations test solutions without moving them into full implementation,” Nirav S. Shah, MD, associate chief medical informatics officer for AI and innovation at Endeavor Health told Becker’s. “Our focus is ensuring we don’t just pilot solutions endlessly. Instead, we build them with scalability in mind.”
Endeavor Health uses a structured rubric for scaling AI, modeled on frameworks like Duke’s “ABCDS process.” This process includes rigorous vetting, engaging frontline clinicians during adoption, and applying stage gates to evaluate effectiveness at each phase.
“This formalized process for vetting solutions avoids simply handing clinicians new workflows without their input,” Dr. Shah said. “It’s an inclusive design approach, ensuring that stakeholders at every level are part of the journey.”
The health system’s scaling strategy emphasizes aligning AI initiatives with strategic priorities, understanding organizational needs, and implementing robust governance. This disciplined approach has allowed Endeavor Health to prevent solutions from languishing in the pilot phase.
Currently, Endeavor Health has deployed more than 100 AI and automation solutions across the organization. A recent success includes the pilot of an ambient documentation tool, which is now being rolled out systemwide.
“From the beginning, we plan for scale,” Dr. Shah said. “We avoid rolling out solutions that will remain on ‘pilot island’ by ensuring operational ownership and rigorous review processes at every stage.”
With AI, Endeavor Health has historically focused on clinical decision support and early disease detection, integrating advanced AI functionality into its EHR and other applications. These tools address a wide range of needs, including fall detection, sepsis monitoring, clinical deterioration alerts, readmission prevention, incidental findings on radiology tests, clinical trial matching, and identifying social determinants of health.
Now, the health system is expanding into areas such as bidirectional chatbots for clinical pathways and consumer engagement, with a focus on optimizing the patient experience, resource allocation, and automating administrative tasks.
“These are areas of opportunity for us, particularly as generative AI has turbocharged our ability to automate administrative tasks in ways that weren’t possible before,” Dr. Shah said.
As Endeavor Health continues to expand AI’s role across the organization, Dr. Shah says the ultimate goal is to create solutions that are not just “innovative but indispensable.”
“By focusing on scalability and clinician engagement, we aim to drive measurable outcomes that directly benefit patients and our care teams,” he said.
