Many health systems are accumulating technology faster than they can put it to work. Pilots launch, tools deploy and then the adoption curve stalls, not because the technology failed, but because the organization was not structured to absorb it.
Dwight Raum, executive vice president and chief digital information officer at Rochester (N.Y.) Regional Health, describes this as the defining problem of the current era in healthcare technology.
“We’ve entered this period of time where we have exponential learning,” said Mr. Raum. “The technologies are enabling us to learn at a pace that we never could have done even five years ago now. But we’re still sitting in a landscape that is regulated, managed, and individuals are dealing with the limitations of the human mind. I’m really curious about how this is all going to roll out.”
What happens when IT change outpaces the ability to absorb it is a tension between what technology brings to the table and how quickly organizations can respond, and individuals can adapt.
“That has all sorts of implications societally and what it means for the generations that follow us,” said Mr. Raum. “But also what does it mean for our values as a society? I don’t have all the answers but as a student of human nature, as a citizen of the world and this country, it’s an interesting time to really see how these things will manifest.”
Many health systems have a window into that reality after implementing ambient listening technology for physicians. Rochester Regional spent two and a half years deploying the technology across nine hospitals spanning urban, community and rural settings in Western Upstate New York, alongside an ambulatory network and post-acute services. That diversity of geography and care settings makes the problem concrete: no single rollout strategy works equally across the system, and adoption is only as strong as the organization’s ability to meet each part of the workforce where it is.
“The organizations that will be successful will have the ability to adapt and change rapidly and accept the enhancements of AI and technology integration,” Mr. Raum said.
The pressure is intensifying. HR-1 and the structural financial changes it carries have accelerated a period in which health systems must do more with less, while an aging population drives demand upward and workforce supply fails to keep pace. Technology is increasingly asked to fill that gap but only if the organizations deploying it can absorb it fast.
Rochester Regional’s ambient scribes rollout showed leadership what absorption done right looks like. A year ago, the system moved from a limited pilot to an enterprisewide deployment. It now has more than 1,000 active users and 67% of clinicians report improved work satisfaction. Providers are reclaiming an average of two and a half hours per week previously consumed by documentation, and after-hours charting has fallen substantially.
“The burnout factor has really been diminished,” said Mr. Raum. “They are really reducing the amount of time they’re spending in notes. The quality of notes has improved as well and then there’s been a huge reduction in pajama time.”
The deployment was structured from the start as a joint effort between Mr. Raum and the system’s chief medical officer, with workforce burden reduction, not technology adoption, as the explicit goal. Rochester Regional’s health informatics team, staffed by several medical directors, was embedded directly alongside providers throughout the rollout to gather feedback, navigate resistance and guide adoption in real time. Their role was not to train users on a new tool, but to navigate the change.
“They play an incredibly important role of helping to be the guides, navigators of that change,” Mr. Raum said. “The organizations that become really successful will figure out how to do this at scale.”
What made the model work was what the health informatics team did with the data it collected. The team pulled granular usage information from the system to identify precisely where providers were struggling and where they were succeeding, then used those data to direct targeted interventions. The feedback loop between data, insight and action became the operational core of the rollout and the mechanism by which the system could identify and close adoption gaps in near-real time.
When a health system genuinely absorbs a new technology, the adoption dynamic inverts. Instead of leadership asking clinicians to use something new, clinicians begin asking when they can have it. That is what happened at Rochester Regional.
“[Ambient] is one of those cases where the technology was in such demand because of the capability it brought that we literally had physicians asking for it, requesting it, to be a part of the program as early as possible,” he said.
The harder question is whether this model can scale. The at-the-elbow approach, placing clinical informatics staff alongside individual providers to guide adoption and close feedback loops, is effective precisely because it is personal.
“The experience at the elbow that we’ve deployed quite successfully for our ambient will work well, but it’s always going to be constrained by the number of warm bodies we can put into that experience; to actually put somebody at the elbow with the clinicians,” said Mr. Raum. “Those organizations that can figure out how to scale change with the application of people but also through the use of technology, hyper personalization, using data to understand how providers are interacting with the system well or for opportunities for improvement. Those who can systematize and integrate that into a feedback loop that can actually drive virtuous change will be the keys of success for the future.”
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