Taking a ‘leadership first, tech last’ approach to health AI

Transcript - Taking a ‘leadership first, tech last’ approach to health AI

Dr. Brian Spisak: I have a motto that I live by, and if you spend any time with me, within minutes you'll probably hear me say this is "Leadership first, tech last."

Kelsey Waddill: Hello, you're listening to Healthcare Strategies: Industry Perspectives. Coming to you from HIMSS 2025 in Las Vegas. I'm Kelsey Waddill, a podcast producer at Informa TechTarget. Eighty-six percent of survey respondents indicated that their healthcare organizations have already adopted AI in some capacity. With AI adoption well underway in the industry, I was curious about whether this technology influences leadership styles and decision-making in healthcare organizations. To find out, I turned to Dr. Brian Spisak, senior partner and chief people and communication officer at Csuite Growth Advisors and program director of AI and leadership at the National Preparedness Leadership Initiative at Harvard University. Brian had a lot of great thoughts to share, so without further ado, let's dive into the conversation.

Brian, thank you so much for coming on to Healthcare Strategies today.

Spisak: I'm happy to be here, happy to share what I know about AI and leadership. Looking forward to it.

Waddill: Yeah, same here. So, before we get too far into the conversation here, I just wanted to give you a chance to introduce yourself to our audience, tell them a little bit about who you are and what you do.

Spisak: In a nutshell, way, way back when I started in behavioral mental health, just after my undergraduate working with adolescents, quickly realized that I needed to go back and get more degrees in advance unless I just wanted to be a glorified note-taker for the rest of my life. So, I went back and eventually got my PhD in social and organizational psychology, but all the while, from beginning of my PhD up until ... I'm like what I like to call “recovering academic.” I was in the academic world for over 10 years, maybe more like 15, but deep at the intersection of human behavior and psychology and technology and how do those two things come together and how can leaders leverage that intersection to find out what are the needs of people and scale solutions. And we'll get into that. And so I did that for many years.

Somewhere along the way, I managed to get an affiliation with Harvard. So I'm currently the program director of AI and leadership at Harvard at the National Preparedness Leadership Initiative, the NPLI. I'm also now, having left the academic world, I'm also senior partner and chief people and communication officer for a boutique advising firm called Csuite Growth Advisors or CGA. And there, which is really exciting, is we work with medium to large health systems to help them define innovation strategies and then we look for solutions to weave into those innovation strategies. So it's all about transformation, but fundamentally first understanding, “What are we trying to transform? Why are we transforming it?” And then we start looking for the technology, for instance, that's necessary to solve those problems, not the other way around.

Waddill: Yeah, definitely. That sounds super exciting. And also, you mentioned transformation there. We are definitely at a transformational point in the healthcare industry with regards to technology and, specifically, AI has been used in the healthcare industry for a while now, but it's reached a new high threshold. And so, I'm excited to hear your thoughts on this phase that we are in right now of that rollout. So, you hosted a panel at HIMSS 2025 called “Lead Your AI, or it Will be Leading You,” which is a great title. But cutting right to the chase a little bit here, what is one thing or more that you wish healthcare leaders knew about leading through a time of AI adoption?

Spisak: So, I have a motto that I live by, and if you spend any time with me, within minutes you'll probably hear me say this is "Leadership first, tech last." We need as leaders to deeply understand the needs and the challenges of our people and the challenges embedded in our processes. And then, once we know that, then we start talking about the technology, but tech comes last. So that's really the first thing that I try to impart when I work with leaders.

One thing I also do is I'm a faculty member at the American College of Healthcare Executives. So I'm fortunate enough to engage with healthcare executives across the country and internationally even, quite frequently. And that's usually, in that course that I give, that's what I impart on them, is this is a time to really challenge us to be better leaders -- and not just managers, but leaders -- really understanding how to guide the future. And the only way we can really do that is we have to know what the real challenges and problems are. And the only way we can do that is really to understand our people and our processes much, much better and much deeper than we perhaps needed to in the past because of this rapid pace of transformation.

Waddill: So given this kind of shift from, I think there's a lot of hype around these new technologies that are coming out for good reason. They can really help our processes in impactful ways, especially with workforce shortages that are happening and other major challenges that the healthcare industry has been trying to address for years. These technologies can really alleviate some of that burden. But as you're saying, that's not the driving force behind it. It's the people making the decisions, the people using the technologies that are the driving force. So why do you think that healthcare leaders sometimes fail to catch on to that point? Or maybe another way to put that, what are some of the pitfalls that healthcare leaders fall into when leading through a time of AI adoption and digital transformation?

Spisak: So, one of the standard things is there's a lot of FOMO, fear of missing out, and I get it. And then you get a lot of people that are hype-mongers, they're really selling hype, and they get up on stages and they get on LinkedIn and wherever else they go, and they really start hyping this up about how this is going to completely change everything and all you have to do is push a button and plug and play, and all of a sudden, magically, all the major challenges that we have in healthcare are automatically going to be solved. So it perpetuates that hype cycle and that also sells books, it sells products, it sells everything.

So there's a whole industry around hyping that up, especially something that's engaging and exciting. When ChatGPT came out, that was pretty mind-blowing. And it was -- I hate to use the term gamechanger -- but it was. And then it was taken to an extreme. So I think that's one of the big issues there, is there's a lot of hype. We need to feel and look like we're being transformative and changing and keeping up with the times, so we move forward. That I think is a big driver.

But what we really need to start thinking about, and I think we're getting past that peak of the hype cycle, and this is where I come in now, this is where I come in to try to put on a parachute. So, we don't go into that sort of Gartner Hype Cycle trough of disillusionment, I'm trying to give a parachute so we can have a softer landing to that plateau where we're actually able to use these things in a safe and responsible way. And the only way we can do that, Kelsey, is -- embedded in that “Leadership first, tech last” motto -- is, for instance, let's take burnout and workforce issues, which I specialize in quite a bit.

There's a mountain of science behind what burnout is. There's a mountain of science behind motivation. So I work with using those frameworks from the applied science to help inform and describe, “What is burnout, and what are the needs of our people?” And then we look at the data, “Okay, what data do we need to inform that so I can make, say, for you a personalized stress profile?” Everybody has a unique stress profile, so how can I use this framework to diagnose you? And it's a diagnostic tool just like any other clinician would use. I use them as an organizational psychologist as well. I'm that kind of doctor.

So I have that diagnostic tool that allows me to collect the relevant data, and then I can create a treatment plan. Once I have that treatment plan, then I can use the technology, the AI, for instance, to scale those solutions, but not before. So it's really understanding the diagnosis, creating a treatment plan, and then using the technology to implement that treatment plan in the most effective way.

So that's what leaders need to know, but we tend to jump in straight into the technology side because there's a lot of people out there saying, "You have to use this right now and it's going to change everything." It's not. It's going to challenge you to be a better leader. And I think that's the exciting space that we're in right now.

Waddill: Definitely. Switching gears a little bit here, I also really wanted to hear your thoughts more on something that I've read from your work outside of HIMSS '25 about organizational ambidexterity and basically the ability for an organization to work with its existing technologies and capacities while also investing in newer innovations is my short little summary, but I would love to hear your more expansive summary. And in this space of AI in healthcare specifically, can you just walk us through a little bit of what that looks like? It sounds quite challenging for organizations to do, but very useful.

Spisak: Yeah, it's pretty straightforward. So again, this comes from the organizational science space, and all that I really use is science-backed and evidence-based. That's another thing. A lot of the people on the hype side, they just pull stuff out of thin air and go, "Here." And so, I think this was my academic background, I really look at strong applied sciences, and one of these is something called organizational ambidexterity, which is founded from something called the “exploration exploitation.” I know it sounds very technical, and it is somewhat technical, but it's very understandable, and it also is very impactful. People have won Nobel Prizes based upon this “exploration exploitation” thinking and the trade-off.

So, really what it is, how do we explore new alternatives so that we can remain innovative while at the same time making sure that we -- “exploit” is the terminology -- but refine our existing processes so that we can remain competitive right now and extract the most benefit from what we've already learned? And so that's a balance that leaders really need to find. How do we make sure that we're going ahead to remain innovative and understand what the future's holding, but at the same time, not going so far ahead that we lose sight of what our core business is and what we do well and refining what we do well? So that's how we have to maintain that balance or ambidexterity, being able to do both at once.

And I recently wrote a paper on this, and I'll share it so the listeners can read it, and there's very specific steps on how you can do that. And it always goes back to first defining what are your needs and your challenges. It always starts with a clear understanding of that. And then we start to look, “Well, do we already have the resources that we need and do we just need to refine them?” So for instance, improving workflows in hospitals and health systems; a lot of the times, and I referenced this in the paper with a colleague of mine, Spencer Dorn, who was a co-author on this did, they just turned some things on in their EHR and they just refined the processes with the technology they already had, which gave them amazing return on their investment without needing to run out and go and get technology.

Then there's been times where there's a need, for instance, trying to give back time to clinicians and looking for ways to do that, say, in the patient encounter. And then you have an example like Kaiser Permanente, where then they started incorporating early on ambient intelligence to help with that patient encounter to document and summarize, which is, by the way, has some pitfalls of its own, but if you do it right, it can save a bunch of time. And then how do you invest that time?

And so, if there's a need that can be solved with existing challenges, you refine, and if you keep looking to refine and the existing solution doesn't do that, then you need to explore. And that's the balance. And you don't want to explore too soon because you might already have the resource to solve your problem in your backyard, rather than going out and spending millions of dollars on yet another solution. So that's a general theme of organizational ambidexterity.

Waddill: Yeah, that's excellent. It makes a lot of intuitive sense, but I'm sure that healthcare organizations can get caught up in one or the other, especially the exploration. It's a little more maybe exciting to look at new options, but not always the way to go. So with that in mind, I think one of the central questions that I was getting at HIMSS '25 was just we are finding the most effective and useful applications for AI right now. The use cases are becoming clearer. And so one of the central questions was when and where is AI best applied? Especially in that context that you were just mentioning of we don't want to be just running around throwing it at any solution possible. We want to know exactly what the best and most useful case is going to be. So I was just curious to hear your thoughts about that. And I know that that could vary based on the organization, but are there any trends that you're seeing there that we can look for?

Spisak: Yeah, I get that question a lot.

Waddill: I'm sure you do. Yeah.

Spisak: And I wish I could just give you a straightforward answer. One trend we are seeing that it has been taking off is ambient intelligence. So AI scribes, though they have their limitations, that seems to really be gaining traction. Some of the other things that I'm interested in, too, are looking at things like patient intake and navigation and helping to, if not automate that workflow entirely, to standardize it and streamline it. So these are some trends that I'm seeing on the sort of more non-clinical side, as it were, because it’s typically a safer bet.

But what I give as a better answer here, and this goes back again to leadership -- and I know I sound like a broken record, but it's so important -- is now what we have to do to, because like you've rightfully pointed out, not all places and systems are the same. So you really need to engage your people from very diverse perspectives. You have to create these cross-functional teams. You have to facilitate a safe space where they can share their perspectives so that you can really understand what are the unique needs for your environment. And that's where I think leadership has to go now, is bringing together diverse perspectives and creating a safe space for people to share not just what they're excited about, but what they're afraid about and what's frustrating them currently without a fear of retribution.

That's why, for instance, I start off every talk I ever give, including the one at HIMSS, with a really crappy joke. That's the stupidest thing you're going to hear all day. I'm starting to use humor to create this safe space so that diverse people can come together and ask the dumb questions about AI, for instance. And usually when I get, "This is a dumb question," it's followed up by one of the most insightful questions I'll get all day long, for instance. And I think that's what leaders need to do now, is make it safe to ask the stupid questions to address their concerns so that people can respond to them. Co-creation. And that's how you get at what's the trends that are relevant for you as a leader and for your organization.

Waddill: Excellent. Unfortunately, that's all the time we have right now for this session. Hopefully, we can have you back on the podcast sometime to have a fuller conversation. But thank you so much, Brian, for coming on and for sharing your insights.

Spisak: Thanks for having me. And as usual, "Leadership first, tech last."

Waddill: Yes.

Spisak: Thank you.

Waddill: Thank you. Listeners, thank you for joining us on Healthcare Strategies: Industry Perspectives. When you get a chance, subscribe to our channels on Spotify and Apple and leave us a review to let us know what you think of this series. More industry perspectives are on the way, so stay tuned.

This is an Informa TechTarget production.