In this AMDIS Roundtable, Dr. Eve Cunningham (Cadence), Dr. Howard Landa (Adventist Health), and Dr. Deepti Pandita (UCI Health) explore what it really means to build an AI-ready EHR. Moving beyond features and vendor roadmaps, they examine how data governance, workflow design, and clinical validation shape the physician’s day — from inbox overload to exam-room disconnect. Together, they discuss shadow AI, cognitive burden, and the hard tradeoffs between optimizing legacy workflows and redesigning care. Their message is clear: the next generation EHR isn’t about adding more technology — it’s about restoring clinical cognition and rebuilding trust in how care gets delivered.

Key Takeaways

• Bad data leads to bad AI — governance must come first.
• AI is math, not magic — noisy and inconsistent data amplify risk.
• Clinical validation is as important as data hygiene for meaningful AI use.
• The EHR disrupts connection when clinicians must focus on screens instead of patients.
• Ambient documentation restores presence but does not yet create a true intelligent clinical partner.
• Most AI tools solve isolated tasks, not the full end-to-end care workflow.
• Health systems need internal prompt and AI literacy — clinicians are not trained engineers.
• Third-party innovation fills gaps, but long contracts slow adaptation.
• Shadow AI often signals unmet needs, not noncompliance.
• Governance should enable safe experimentation rather than block innovation.
• Clinicians remain accountable for AI-driven decisions under current regulations.
• Patients are rapidly adopting AI tools, often without reliable guardrails.
• AI’s highest near-term value is reducing cognitive and administrative burden.
• True progress requires redesigning workflows, not endlessly optimizing legacy processes.
• Leadership prioritization, not technology limits, often slows transformation.
• The next generation EHR must restore clinical cognition and trust.

Episode Highlights

00:00 | The Key to a Successful EHR: Restoring Clinical Cognition 02:36 | When the EHR Slows Care Instead of Supporting It 01:08 | Why This Isn’t About Features or Vendor Roadmaps 02:36 | When the EHR Slows Care Instead of Supporting It 03:46 | AI Is Math, Not Magic 04:05 | Data Governance as the Prerequisite for AI 05:23 | Governance + Clinical Validation = Actionable Intelligence 06:44 | The Keyboard Breaks the Sacred Patient Encounter 08:25 | Ambient Tools and the Return of Joy in Medicine 09:19 | The “Intelligence-Ready” EHR Vision 11:10 | Why Clinicians Aren’t Prompt Engineers 12:39 | Is Epic Cosmos Ready for Prime Time? 14:01 | Contextual, Specialty-Specific Views at the Point of Care 15:08 | Third-Party Innovation vs EHR Vendor Lag 16:49 | When to Replace vs Layer New AI Tools 18:09 | Shadow AI as a Signal of Unmet Need 19:08 | Enabling Safe Experimentation Through Governance 20:55 | If AI Makes a Mistake, Who Is Liable? 23:35 | Where AI Should Help First: The Patient Journey 25:19 | Patients Are Already Using AI for Medical Advice 27:33 | Cognitive Scaffolding: Removing Clinical Noise 28:31 | Intelligent Synthesis vs Data Mining 29:13 | The Peer Challenge: How Do We Move 2–3x Faster? 30:02 | Leadership Indecision Slows Transformation 30:47 | Stop Optimizing Legacy Workflows 31:46 | Final Message: Technology Isn’t the Barrier Anymore

Guests: Dr. Eve Cunningham, Dr. Howard Landa, Dr. Deepti Pandita Host: Gregg Malkary – Lighthouse Healthtech Cohost: Keith Washington – Companions in Courage Foundation Sponsored by: Simplifi Medical & Storage Systems Unlimited Audio/Video: Tim Jones – Health Nuts Media Marketing: Josh Troop – Troop-Creative Learn More at: www.beyond-blueprint.com