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Michael Marcotte is founder, chairman and CEO of artius.iD, a digital identification company.

Health systems need to invest in top talent and utilize AI tools to protect their organizations.

Healthcare industry must brace itself for deluge of cyberattacks in 2025 | Viewpoint

By 2050, it's estimated that 139 million people worldwide will have dementia, but by today's standards, 60% will be undiagnosed. It's clear that there's a significant gap in dementia detection and care, but what can your organization do about it?

Get perspectives from clinical leaders and neuroscience experts about the underlying causes and consequences of these gaps, practical opportunities to address them, and a proven roadmap that shows how leading health systems have successfully transformed their dementia screening and care processes.

Closing the Dementia Care Gap: Expert Insights and Proven Strategies for Health Systems

Plenty of healthcare leaders say they are excited about the potential of artificial intelligence in delivering better care, but a leading patient safety group is warning of possible harm to patients.

ECRI, a nonprofit organization, placed AI on 

its annual list of the top threats facing patients in 2025

. AI landed near the top of the list, ranking second behind only the dismissal of patient and family concerns about. AI also ranked among 

Marcus Schabacker, MD, president and CEO of ECRI, has voiced concerns about the use of AI in the healthcare industry. He’s not opposing the development and use of AI by hospitals and clinicians, but he fears there aren’t enough safeguards. He outlined those concerns in an interview with Chief Healthcare Executive®.

“We continue to have concerns because, particularly the larger healthcare providers … they don't have a good governance structure to oversee the utilization of AI,” he says. “And you don't, you know, have to stretch your imagination too far to think that if you do not have good governance in place, these new tools can be abused or used in the wrong context.”

(See part of our conversation in this video. The story continues below.)

Dr. Marcus Schabacker of ECRI calls for more protections for AI in medicine

AI in health care needs safeguards for patient safety

Schabacker says health systems that are going to be using AI in patient care need to have strong governance structures in place.

Before health systems adopt AI tools, Schabacker says that leaders should ask, “How was that AI developed? What is the testing pool? Is there an intrinsic bias in the testing pool?”

He notes that AI models that have been tested on healthy, young white men won’t necessarily be as successful with older Latino men.

ECRI has advocated for more disclosure on AI tools, similar to the nutrition labels found on foods in the supermarket. He said there needs to be more transparency about the study pool and statistical methods of AI algorithms, along with information about the testing.

Many hospitals are focusing on using AI technology to automate some tasks and ease some burdens for workers, such as filing claims or documenting patient visits. Some health systems are using AI tools for clinical uses, including supporting a diagnosis. 

But with doctors facing demanding schedules and pressed to see as many patients as possible, Schabacker worries that clinicians could become overly reliant on AI tools in making a diagnosis.

“These tools, which are claimed to be decision-supporting, very quickly become decision-making,” Schabacker says.

If doctors are pressed for time, he says, “You are going to rely on anything which seems reasonable.”

Schabacker says if technologies haven’t been thoroughly tested, doctors could end up using solutions that could provide “a very wrong recommendation.” 

“When you tend to rely on those recommendations, they become very quickly decision-making tools, and that's what really concerns us,” he says. “And there's very, very little oversight.”

Schabacker also said he’d like to see more oversight from the government of AI tools.

“A lot of these AI tools are labeled as decision support, which then requires little or no oversight from the federal government at all,” he says. “And that, to us, is the biggest concern.”

ECRI says AI could lead to medical errors that lead to injury and death. The group also says the use of AI tools could make it more difficult to determine if patient complications are tied to AI, and that could make it harder to identify mistakes. 

Researchers at the University of Minnesota School of Public Health have looked at the growing use of AI in hospitals, and found some areas of concern.

Two in three American hospitals (65%) are using AI-powered predictive models, according to 

 published by Health Affairs in January. Hospitals are using the tools to project the health trajectories of patients and identify patients with higher risks of complications after they leave the hospital.

But not all hospitals reported safeguards on the performance of those models. Researchers found 61% of hospitals were examining their predictive models for accuracy, while 44% were examining those models for bias. Hospitals with better funding were more likely to have developed methods to analyze their models for accuracy and bias.

 (66%) say they’re using AI in some form of their practice, up from 38% in 2023, according to an American Medical Association survey released last month.

Doctors are “increasingly intrigued” by the potential of AI technologies to develop better and more personalized treatments, Jesse M. Ehrenfeld, MD, the former AMA president, said in a statement accompanying the survey.

“But there remain unresolved physician concerns with the design of health AI and the potential of flawed AI-enabled tools to put privacy at risk, integrate poorly with EHR systems, offer incorrect conclusions or recommendations, and introduce new liability concerns,” Ehrenfeld said.

Many healthcare leaders say artificial intelligence offers the promise of improving care. Marcus Schabacker, CEO of ECRI, says there need to be more safeguards.

Topic

Why AI remains a top concern for patient safety

Too many patients and family members are struggling to be heard by doctors and clinicians, and it’s emerging as a key problem in protecting patients.

In fact, ECRI named the dismissal of patient and family concerns as its top concern in the organization’s annual list of threats to patient safety. ECRI, a non-profit organization focused on patient safety, released 

its 2025 ranking of patient safety concerns

Too many patients are experiencing the equivalent of “medical gaslighting,” says 

In an interview with Chief Healthcare Executive®, Schabacker says he doesn’t think doctors are intentionally engaging in “gaslighting,” the term used for deceiving or manipulating individuals into believing a false reality.

“We don't think there's a provider out there, a clinician out there, who goes to work and says, ‘Oh, I'm going to ignore patients’ concerns today,’” he says.

“We don't think that physicians are trying to mislead patients in a certain way,” Schabacker explains. “That's not what we're saying. But what we're saying is there's just not enough attention paid to what patients really say and what their symptoms really are.”

He also points out that 25 years have passed since the landmark report from the Institute of Medicine, “To Err is Human,” which found that 98,000 deaths due to medical errors occur in U.S. hospitals. And he says there’s still a great deal of work to do.

“We just haven’t made enough progress in patient safety,” Schabacker says. 

Dr. Marcus Schabacker of ECRI talks about leading threats to patient safety

Top patient safety threat: Doctors dismissing patients

Schabacker says too many patients, families and caregivers are raising concerns to clinicians and physicians that aren’t being heard or are outright ignored.

Part of the problem is that physicians are carrying such high workloads and seeing so many patients that they aren’t listening as much as they should.

“We are so pressed for time that these basic things, these basic clinician skills of listening, just get lost,” he says.

As doctors face demanding schedules and are pushed to see as many patients as possible, they can also be susceptible to leaning heavily on a suspected diagnosis.

“It’s called confirmation bias, whereas you're just trying to confirm what you already think is happening,” Schabacker says.

Health systems and other providers must think beyond using technology to improve the organization, he says. Technology alone won’t improve a flawed process.

“So when we are just introducing new technology in an already stretched system where providers don't have a lot of time, providers are not allowed to appropriately interact with the patient, they're going to jump to conclusions,” he says.

Too often, Schabacker says women and members of minority groups don’t feel as if they’re heard by their clinicians. He says it’s a particularly difficult issue for women who are members of racial or ethnic minorities.

He adds that physicians must also make an extra effort to make sure they are understanding the concerns of patients with disabilities and cognitive impairments. “It really takes time, and that's the one thing the clinicians today don't have,” he says.

Even acknowledging those understandable pressures, Schabacker says it’s critical for physicians and clinicians to take a breath and make sure that they are really listening to their patients, or the family members or caregivers. He says it’s critical to ensure patient safety.

“You can learn a lot, and at the end, you’re actually going to save time, and you're going to prevent patient harm,” he says.

Hospital and health system executives can do better by making sure that clinicians have sufficient time to have a conversation with their patients.

“You need to create an environment where that kind of positive interaction with the patient is rewarded,” he says.

And there’s no getting around the need for appropriate staffing, he adds.

“The cost is going to be much lower because we're not going to have as much misdiagnosis. We're not going to have as many wrong treatments, ignored treatments. Patients are not going to go to multiple providers because they finally want to get heard,” Schabacker says.

ECRI’s list covers concerns regarding several different facets of care, including the use of artificial intelligence in healthcare. ECRI names insufficient governance of AI in health care as the second leading threat to patient safety this year. 

AI also ranked near the top a year ago on ECRI’s list

The growing prevalence of medical information ranked third on the list. Schabacker warns of the dangers of consumers trusting what they see on social media or a web article rather than information from clinicians and healthcare experts.

“Just because something has 100,000 clicks doesn't make it right,” he says. “There's a lot of information there which gets disseminated, which has no scientific evidence based backup whatsoever.”

Here’s ECRI’s full list of its top concerns for patients in 2025.

1. Dismissing patient, family, and caregiver concerns;

2. Lack of governance of artificial intelligence;

5. Caring for veterans in non-military health settings;

7. Diagnostic error in cancers, vascular events, and infections;

8. Healthcare-associated infections in long-term care facilities;

9. Inadequate coordination during patient discharge;

10. Deteriorating working conditions in community pharmacies.

The dismissal of patient and family concerns rose to the top of ECRI’s annual list of threats to patients. Marcus Schabacker, ECRI’s CEO, talks with us about the need to listen to patients.

The leading threat to patient safety: Not listening to patients and families

 - After the ViVE conference in the Music City, it’s looking like AI won’t be a one-hit wonder for the healthcare industry.

The conversations about AI dominated the digital health conference, which probably isn’t a surprise. But it still can’t be ignored.

Here are five quick takeaways, and they’re not all about AI.

(Here’s a video roundup of ViVE. The story continues below.)

Thousands came to ViVE in Nashville for discussions on AI, cybersecurity and more

ViVE: Highlights from the digital health conference

It’s not just that people are talking about AI in healthcare, but why they’re so enthusiastic.

Hospital and healthcare executives are seeing more evidence that AI-powered technologies are capable of helping their organizations.

Healthcare leaders say they’re especially encouraged about ambient listening tools that record and summarize clinician conversations with patients, saving doctors and nurses time in documentation and reducing stress.

Marty Bonick, president and CEO of Ardent Health, said the system is seeing promising results in using AI documentation technology.

“I do think we are at the point where technology is going to start working for our caregivers and our patients, versus the other way around,” he told Chief Healthcare Executive® in 

, president of the Mayo Clinic Platform, said Mayo is using ambient documentation in Arizona and Florida, so nurses don’t need to touch a keyboard to summarize notes. And AI algorithms at Mayo are showing high degrees of accuracy, he said.

In a conversation on one of the main stages at ViVE, Halamka said, “We really are at the point in 2025, the data is good enough, the technology is getting good enough, the compute is getting available enough, and the use cases are getting clearer. So next year, we talk about what's real.”

One other note: healthcare executives are showing that they’re not just going to buy an AI tool to get the latest gadget or tech. They’re looking at AI tools that solve their problems, but aren’t inclined to try a solution and hope they can find a problem for it.

Doctors seem to be very enthusiastic about using AI documentation tools to reduce the number of hours they spend on documentation, including the dreaded “pajama time,” healthcare leaders and physicians say at ViVE.

However, doctors have some concerns about the increased efficiency AI could provide. Doctors welcome using AI to reduce their documentation demands and have more time to spend with their patients (and with their families). But doctors are worried that the added efficiency means they’ll be asked to see more patients, and spend less time with patients.

chief clinical innovation officer of Medrina, said he hears from AI vendors telling him that they’re solutions will enable him to see more patients.

“I'm like, I don't know if I want to see more patients. I want to provide better care,” Tariq said.

Nurses also say they welcome using AI tools

 and other technology, but they need solutions designed with them in mind.

Jing Wang, dean and professor of the Florida State University College of Nursing, said, “There are a lot of nurses who are very pro-AI.”

But nurses also want to be sure the tools mesh with their workflows, and protect patient safety. Hospital leaders need to consult nurses before deploying tools, and talk with nurses who have concerns about new solutions.

ViVE featured a series of discussions on cybersecurity, and it’s clear that remains a pressing concern among hospital and healthcare leaders.

John Riggi, national advisor for cybersecurity and risk with the American Hospital Association, 

outlined the growing threats of cyberattacks

, noting 259 million people in the U.S. were affected by breaches of health data.

Riggi stressed that hospitals and health systems must work to deter attacks and be prepared for disruptions when breaches happen. He also stressed that many hospitals are being affected by breaches of their business partners and vendors. “The bad guys have figured out often our third parties and business associates are less secure than we are,” Riggi said.

There seems to be growing frustration among hospitals about being blamed for breaches of their partners.

He also said that most healthcare cybeattacks are launched from ransomware groups outside the U.S., and the government needs to do more to disable those organizations.

Anika Gardenhire, chief digital and information officer of Ardent Health, outlined 

her system’s recovery from a cyberattack

. She stressed the importance of preparing for attacks. As she said, “It’s really not a matter of if. It’s just a matter of when.”

John Couris, president and CEO of Tampa General Hospital, 

 and urged hospitals and health systems to prepare for weather emergencies. His system regularly confronts risks of hurricanes, but he said all health systems need to prepare for more intense storms, wildfires, and flooding.

 with Chief Healthcare Executive®, Couris said the key for health systems is, “You need to be constantly planning.

“This can't be sort of like, well, we focus on it four months out of the year, because that's when we're most vulnerable for natural disasters,” he said. “Wherever you are in the country, you need to be constantly doing it.”

Couris acknowledged those efforts can be costly.

““This stuff's expensive,” he said. “But you know what's even more expensive? Not doing something.”

Leaders at ViVE acknowledged that too many patients aren’t getting the care they need. Too many can’t afford care, or they don’t have easy access to doctors.

the conflicts between hospitals and insurers over claim denials

, several healthcare leaders noted that it’s the patients that are suffering when they can’t get approval for treatments, or their care plans are delayed.

““Who falls through the gap? It’s the patient,” said Rick Gundling, senior vice president of healthcare financial practice at the Healthcare Financial Management Association.

Dr. Soumi Saha, senior vice president of government affairs at Premier, Inc., said that many patients don’t have the energy to keep fighting for care.

“We know that patients that have to go through this process, many of them abandon care,” Saha said.

AI consumed conversations as expected, but conversations are getting more nuanced. The annual event also revealed more anxiety about pressing problems.



Five from ViVE: Takeaways from the digital health conference

 – Hospitals and physicians have grown increasingly frustrated about insurers denying claims, saying it costs them time and money while hurting patient care.

At the ViVE digital health conference, a panel of healthcare leaders expressed optimism that technology and artificial intelligence can offer some relief, but they also said that the solution won’t be solved simply by technology.

Dr. Soumi Saha, senior vice president of government affairs at Premier, Inc., says AI isn’t a panacea.

“The process itself is broken,” Saha said. “So you can't just simply put tech or AI on top of this broken process and hope that miraculously it solves all the issues that we're facing day on day out.”

“And so you have to go back to step one, in many ways,” she said. “Fix the process first, and then let's think about, as we're fixing that process, what is the role of technology and AI as part of a new process?”

ViVE brings healthcare voices to Nashville

Premier examined claims from 2022 and found that 15% of all claims are initially denied, including some that had pre-approval from insurers. Providers and hospitals are spending $20 billion annually into fighting administrative claims, Saha said. On average, hospitals are spending about $44 per claim to adjudicate back and forth.

Saha said Premier is going to release new data on the costs of denials within the next few weeks, but she did offer a preview of the upcoming findings.

“Here’s the spoiler alert: nothing has changed,” Saha said.

Premier found similar rates of denials of claims. But she said one key change is the rising costs of fighting those claims, which is now almost $10 per claim higher “because of just simply how much labor costs in health care right now.”

Ash Shehata, KPMG’s U.S. sector lead for healthcare, moderated the discussion. "I think the pressure seems to be mounting a little bit on change," Shehata said.

Tensions between hospitals and insurers are growing, said Rick Gundling, senior vice president of healthcare financial practice at the Healthcare Financial Management Association. His group has surveyed insurance executives and hospital leaders about the increased conflict.

“From our standpoint, it's really become much more contentious between the two,” Gundling said.

Both payers and hospital systems have been using more AI tools to automate the process of filing claims, Gundling said. Healthcare leaders have said that using those tools should streamline claims and help ensure that all the requirements are met, thus improving the process and removing friction. But it hasn’t exactly worked out that way.

As more claims are denied, Gundling said, “It’s turned providers, hospitals, into collection agencies.”

Azlan Tariq, chief clinical innovation officer of Medrina, said AI has the potential to streamline the claims process. But he also pointed out that electronic health records were billed as a tool that would reduce headaches on clinicians, and many doctors cite the time they spend on documentation as a leading cause of burnout.

“We're spending more time in front of the computer now and less time in front of the patient,” Tariq said.

Providers and hospitals aren’t the only ones suffering, Gundling added. 

Most doctors say delays and denials of claims hurt patient care

, according to surveys by the American Medical Association.

“Who falls through the gap? It’s the patient. It’s the consumer,” Gundling said.

Some of the most problematic areas of denials involve providers aiming to move patients into post-acute care, which is a common source of tension between hospitals and payers.

‘It's really challenging, and it's a significant opportunity there to make things faster and better,” Tariq said.

For patients who have encountered denials, especially after an insurer gave pre-approval, the delays can be maddening.

“That is devastating to a patient who thought that they went through the process correctly in order to ensure that their bill was going to be something that they could tackle at the end of the day," Saha said. "So, the patient implications are huge."

"Also, just in general, we know that patients that have to go through this process, many of them abandon care, because they just don't have the time or effort to get on the phone," she added. "They don't understand the process. And so, you see a lot of care not being provided."

If patients are struggling or stressed with denials or delays in treatment, hospitals can pay a price as well, Saha said.

“There is a link between denials and patient satisfaction,” Saha said.

Healthcare leaders talked about the frustration hospitals and doctors are facing when insurers reject claims, the impact on patients, and the need for a better process. 

Michael Marcotte

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