I didn’t leave medicine behind when I stepped out of the operating room. I carried its lessons with me into leadership. Today, I see myself as a leader who also happens to be a physician, and that perspective shapes how I approach the challenges and opportunities in healthcare.
Early in my career, I saw just how hard our work is — and how much improvement is needed across our industry. I saw the weight on our teams, the stress on our doctors, nurses and care providers, and the relentless demands of care delivery. My goal when I entered leadership was to unburden our teams from non-value work so they might rediscover the joy in our profession.
There’s only so much we can achieve through human process redesign alone. The giant leap to relieve overburden and restore joy in medicine requires something more: the advances that technology and AI offer.
Several years ago, I was introduced to the possibilities and promise of technology and digital innovation. The potential is transformative. These advances aren’t about replacing humans and human connections; instead, I believe they’re about enabling our teams to work at the top of their licenses and to attract and retain the best talent, which will translate into delivering the highest-quality care for patients.
This belief — guided by five core tenets — shapes how we approach innovation at Duke Health today.
1. Innovation starts with purpose
At Duke Health, we’ve developed a disciplined, systemwide approach to innovation and technology adoption. It starts not with a product, but with a problem. We ask: What is the core pain point? What’s at stake for our patients, our teams, our mission? Only after we define the issue do we begin evaluating solutions. Even then, we follow a full Plan-Do-Check-Adjust cycle to assess outcomes, adjust as needed and determine if the value created justifies scaling.
We don’t chase trends or implement tech because it’s new. We implement what drives sustained value.
2. From problem to progress: easing documentation burden
One of the clearest examples of this mindset is how we approached provider burnout tied to EHR documentation. Our clinicians were spending more time charting than caring, and it was taking a toll.
Through our BLUETEC Fund — which empowers Duke to invest in technology that addresses pressing clinical and operational challenges — we partnered with Abridge, a company that offers ambient AI to generate clinical notes from physician-patient conversations. The pilot was small and carefully measured. The results were clear: providers overwhelmingly preferred the AI scribe, and we saw meaningful reductions in documentation time and provider burnout.
Today, more than 2,000 Duke Health providers are using this technology across the enterprise — not because it’s interesting, but because it works.
3. Innovation from the inside out
Some of our boldest ideas come from within. Through the Duke Institute for Health Innovation (DIHI), we invite front-line clinicians and staff to propose technology solutions that solve real problems. In 2024, we focused on AI that could improve operational efficiency, and the response was remarkable.
One notable project leveraged AI to streamline the prior authorization process by ensuring accurate clinical documentation for medication and procedure eligibility. Another project employed AI to enhance physician handoffs in the cardiothoracic ICU by creating concise summaries that facilitate effective patient transitions and reduce clinician workload during shift changes.
These early wins inspired Scout, a powerful agentic AI tool, also developed by DIHI, that searches EHR data to extract, organize and present key patient details in a clear format, aiming to decrease the time clinicians spend on documentation and enhance care quality. Scout not only supports clinical care workflows, it also supports our academic research mission as well.
And innovation doesn’t stop with clinicians. Every year, our Nursing Innovation Summit invites bedside nurses to pitch new ideas. One recent concept — using blue light in clave connectors to prevent bloodstream infections — was developed in collaboration with Duke engineers and is now advancing toward product viability.
That’s the power of listening to people closest to the problem and giving them the tools to lead the solution.
4. Smart partnerships, shared values
Not every solution is homegrown. At times, our greatest leaps forward come through strategic partnerships, and we treat those collaborations as seriously as we treat patient care.
We have an incredible partnership with Microsoft. Together, we’re scaling secure, ethical and transparent generative AI tools across our workforce. These tools are improving productivity and resilience. Importantly, they’re built with safety at the core.
For example, our strategic alliance with nference aims to unlock the research potential of clinical data without ever compromising patient privacy. Their platform helped us turn decades of unstructured clinical records, radiology images and digitized pathology slides into structured, meaningful insights — accelerating discovery while maintaining full control over every data point.
We don’t license tools and hope they fit. We align with partners who share our commitment to integrity, safety and long-term value.
5. Innovation that serves a mission
At Duke Health, we are innovating to serve: to deliver better outcomes, reduce inefficiencies, bring joy back to care delivery and create a more resilient health system. Our approach is deliberate and evidence-based, but it’s also deeply human.
We start with empathy. We lead with insight. And we measure success not in headlines, but in impact.
Technology is not a strategy. It’s a strategy-enabling tool — one that only works when applied with care, clarity and purpose.
That’s how we’ll meet this moment. And that’s how we’ll shape what comes next.
Craig T. Albanese, MD, MBA, is CEO of Duke University Health System — North Carolina’s fourth-largest employer and one of the nation’s top academic medical centers. A respected surgeon scientist and clinical investigator, Dr. Albanese is responsible as CEO for strategic and operational oversight of DUHS and its senior leadership. He joined DUHS as executive vice president and chief operating officer in January 2022 and was named chief executive officer in February 2023.
