Zafar Chaudry, MD, has spent 40 years in healthcare IT — the last 8.5 of them at Seattle Children’s, where he serves as senior vice president, chief digital officer and chief AI and information officer. He started his career as a physician, a background that still shapes how he thinks about technology.
“I’m one of those folks that has defected to the dark side over many years and now fully embedded on the technology side,” he said during an interview with the “Becker’s Healthcare Podcast.”
That clinical lens is evident in how Seattle Children’s approaches artificial intelligence. Before fully committing to AI, Dr. Chaudry’s team spent about 18 months rebuilding the organization’s data foundation, migrating from an on-premises IBM Netezza warehouse to a full Google Cloud platform. Today the data lake pulls from 171 systems and supports a growing operation.
“The question was, how do you get the right information into the right place? Because that’s the information you’re going to need to build your AI models so that they’re accurate and are beneficial to an organization,” he said.
Out of that foundation came the organization’s first agentic AI tool, which the team calls Pathway Assistant. It draws on thousands of pages of clinical pathways Seattle Children’s has developed over the years — content the organization freely shares with hospitals around the world — and makes them queryable through a conversational agent.
“If you’re a new physician and you’re trying to learn how to practice medicine in pediatrics, you can tell the agent about your patient, the age, the weight, the symptoms, what’s going on with the patient,” said Dr. Chaudry. “The agent will look at all the information it has access to and start guiding that physician through the care pathway for that patient.”
For veteran clinicians, the use case shifts into a validation tool. They can cross reference differential treatment plans based on the patient’s diagnosis, which has been successful.
“It becomes like a ‘phone a friend’ and you’re able to query it and get the answers you need,” said Dr. Chaudry. “That’s one example of an agentic AI that we built.”
Seattle Children’s tapped 50 physicians to each contribute roughly 100 hours to building, testing and refining the tool, and that same group continues to validate it as new pathways are added. Technology leaders worked closely with the physicians to develop and iterate on the agents. This kind of partnership is what separates a lasting AI solution from a forgotten one.
“If it’s only driven by IT because it’s the next shiny toy, you’re not going to get adoption and you’re certainly not going to get the most important thing in AI, which is sustainability of solutions. Because it’s easy to create something shiny and then people won’t use it after a few weeks,” he said.
Seattle Children’s is also rolling out an enterprise ambient AI transcription license across its physician workforce, a move that has generated some of the strongest clinician feedback Dr. Chaudry has seen.
“Many tell us that they would never allow us to take this tool away from them,” he said. “That’s another win we’ve had in the AI space.”
Not every impactful technology is AI-powered. One of the most meaningful tools to come out of the organization’s patient and parent advisory group, which meets monthly with Dr. Chaudry’s team, was a surgical status tracker built into Seattle Children’s digital front door app. Families had told the team they felt trapped in the surgical waiting area, sometimes for hours, afraid to step away and miss an update on their child. The solution was swift: parents receive a code that lets them follow their child’s real-time status through the app or a waiting room display board.
“That’s a really small thing, but it’s a big thing to someone who is super worried about their child and doesn’t want to move from one location,” Dr. Chaudry said.
Heading into 2026, fiscal discipline is top of mind. Federal policy changes and their downstream financial impact on the health system represent his biggest wildcard.
“I think the hardest thing for us in ’26 will be deciphering the impact on our health system around the big bill that was approved, and then for me in IT, trying to figure out what that means financially to my budget. Because I have to right size my budget, balance my books, and still continue to provide the services that our stakeholders and our patients and our parents need,” he said. “Those costs aren’t coming down. So this year, we’ll have to be very, very careful around continuing to innovate, but also continuing to do more for less and be fiscally responsible.”
His approach involves ongoing application rationalization across more than 1,000 systems, aggressive vendor contract negotiations and continuous IT asset management. On renewals, his team doesn’t accept increases passively.
“We always fight back. So when a renewal comes through, we look at the renewal. We see how much it has gone up. We then go back and forth and fight the good fight to make sure that the increase isn’t too taxing on our budgetary model,” he said.
Despite the financial pressures, growth is on the horizon. Seattle Children’s is planning new clinic locations and additional ambulatory centers across the Pacific Northwest to meet rising patient demand. The mission driving all of it — the AI agents, the surgical tracker, the vendor negotiations — remains the same.
“The more you can communicate your challenges to your end users, the more helpful they can actually be in partnering with you to deal with the challenges ahead,” he said.
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