Health system CIOs told Becker’s they convince their CFOs of the value of AI by thoroughly outlining the return on investment, even if it might be far off into the future.
Michael Mainiero, senior vice president and chief digital and information officer of Rockville Centre, N.Y.-based Catholic Health, said AI isn’t a tough sell nowadays, as many of his fellow senior executives, like the CFO and clinical leaders, are eager to explore the technology.
“The real challenge is staying focused on outcomes,” he said. “It’s easy to chase technology, but we’ve made it a rule to avoid ‘AI in search of a problem.’ We begin with structured hypothesis work for every initiative: Can we do this? Should we? Will it create measurable value? That discipline upfront helps us align on feasibility, ROI and operational impact.”
Mr. Mainiero has partnered with his CFO’s team to deploy robotic process automation in the revenue cycle for cost savings, increased efficiency and accelerated collections.
“We start small, set clear outcome criteria early, and create space to pivot, expand or abandon based on results,” he said. “These expectations are set from the beginning — avoiding overpromising and giving teams a shared definition of success is essential.”
Reid Stephan, vice president and CIO of Boise, Idaho-based St. Luke’s Health System, said he often frames AI projects in terms of “cost avoidance, risk mitigation and improved outcomes.”
“AI projects shouldn’t be viewed solely through the lens of immediate ROI, but rather as strategic investments in future efficiency, quality and resilience,” he said. “For example, we implemented an AI-driven clinical documentation tool that didn’t show instant savings but reduced physician burnout and improved coding accuracy — outcomes that translated into long-term financial and clinical gains.”
Aaron Miri, DHA, executive vice president and chief digital and information officer of Jacksonville, Fla.-based Baptist Health, said he gains the consensus of his peers in the C-suite by having a “unified governance structure.”
“At Baptist Health, we evaluate AI solutions via a multistakeholder, physician co-led governance and supported by numerous functions, such as nursing, compliance, legal, IT and ethics,” he said. “This AI committee looks at responsible use of the tool — like what problem are we trying to solve and why? — and establishing KPIs and other benchmarks.”
Dr. Miri said he and the team also closely evaluate the security architecture and applicable state and federal regulations to ensure they are “eyes wide open” on the project. Baptist Health uses the same process to create novel AI solutions.
If partnering with a vendor, the health system works to iron out acceptable terms, Dr. Miri said: Does the vendor only get paid when the AI solution works and KPIs are met? Should success metrics be incentivized?
“The bottom line is a strong, measurable, transparent and responsible multistakeholder governance function leads to better shared decision-making and thus a tangible ROI on the investment, which drives trust, even if that ROI has a variable time horizon to realization on the balance sheet,” Dr. Miri said.
