Most health systems adopting AI are layering new tools onto hospitals, workflows and IT platforms built decades earlier. The University of Texas at Austin is trying something few organizations get the chance to do: design an academic medical center around AI before construction begins.
Claudia Lucchinetti, MD, executive vice president for medical affairs and the UT Dell Medicine health system, has a name for the approach she wants to avoid. She calls it the “tentacle problem” — “another workflow, another technology tacked onto a broken chassis.” The goal instead, she told Becker’s, is to “fundamentally rethink the care continuum.”
UT Dell Medical Center recently received its permit, and ground clearing is set to begin this month, Dr. Lucchinetti said. Design work is past the halfway point of the schematic phase. The medical center will open in three phases from 2030 to 2032, with the first phase opening with full capabilities and seeing the first patients, she said.
Dr. Lucchinetti spoke with Becker’s shortly after Dell Medical School hosted the UT System’s REAL Health AI Symposium Oct. 7-8 in Austin, a two-day event she said drew more than 900 attendees. She described the medical center as a convergence also reflected by the symposium: bringing clinical care, research, technology and entrepreneurship together at a university with deep expertise in AI, computing and engineering, and doing it from the ground up.
That changes what the medical center is built to do, she said. Caring for “the sickest of the sick” remains important and needed, but it isn’t enough.
“Our standard is to be a medical center that can anticipate, react, intervene, change, and those principles are different when you’re architecting them from the ground up,” Dr. Lucchinetti said. “We all have the same goal, but few have the once-in-a-generation moment to leverage this convergence.”
In practice, that means building a single integrated care model with one digital architecture and one shared record, in partnership with Houston-based University of Texas MD Anderson Cancer Center. Dr. Lucchinetti said the hospital itself should do more than house the care team; it should contribute to the team’s work, with the ability to sense, act and intervene.
The design questions start with people, she said: how patients will move through care, what clinicians will need, how research will inform clinical decisions and how patients’ experiences will shape the next research question.
Prevention is central to that design. Dr. Lucchinetti said AI, sensors, imaging and modeling are increasingly revealing patients’ health trajectories earlier, sometimes on a test ordered for an unrelated reason. She pointed to the widening gap between life span and health span, noting the U.S. has the largest gap of 183 countries.
“We live longer, but we live longer sick,” she said.
To describe the opportunity, Dr. Lucchinetti borrowed an idea raised at the symposium by OpenEvidence CEO Daniel Nadler, who invoked philosopher Martin Heidegger’s concept of poiesis: bringing something new into being. For the medical center, she said, that means creating new forms of care rather than simply making existing tasks faster.
That ambition comes with obligations, she said, particularly for a state university entrusted with public resources.
“The most important currency of what we do will be to earn public trust,” Dr. Lucchinetti said.
That starts with making sure patients understand when AI is involved in their care, she said.
“We need to protect privacy, explain limitations. We need to continue to honor the patient-physician relationship or the patient-healthcare provider relationship,” Dr. Lucchinetti said.
She also flagged the risk of deskilling, citing research in which clinicians who used an AI tool to help identify potential malignancies during colonoscopies were less effective at doing so on their own after three months of use.
“We just have to be really cognizant about those trade-offs, and we also have to recognize a more technological health system is not automatically a more humane one,” she said.
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