Podcast Summary: AI Governance and Digital Access at Mount Sinai Health System

Podcast: Becker’s Healthcare Podcast
Episode Date: February 22, 2026
Guests:

• Girish N. Nadkarni, Chair of the Windreich Department of Artificial Intelligence and Human Health, Director of the Hasso Plattner Institute for Digital Health, Chief AI Officer, Mount Sinai
• Dr. Nicholas Gavin, Vice President and Chief Clinical Innovation Officer, Mount Sinai
  Host: Laura Dardel

Episode Overview

This episode centers on Mount Sinai Health System’s leadership in responsible AI governance and digital health innovation, with a deep dive into their expanding digital front door, asynchronous care models, and the challenges and opportunities in healthcare access for 2026. Girish Nadkarni and Dr. Nicholas Gavin share insights on leveraging technology to transform patient care, how they’re creating robust oversight for AI deployment, and the system’s ambitions to become the most consumer-oriented and learning-focused health system in New York City.

Guest Introductions

[01:02]

• Girish Nadkarni: Clinician (internist and nephrologist), clinical informaticist, with extensive experience in AI implementation and deployment. Leads Mount Sinai’s AI initiatives.
• Dr. Nicholas Gavin: Emergency physician, inaugural Chief Clinical Innovation Officer, and clinical informaticist. Overseeing innovation across Mount Sinai’s eight acute care hospitals and hundreds of clinics.

Key Discussion Points & Insights

1. Expansion of Asynchronous Care

[02:24] Dr. Nicholas Gavin

• Mount Sinai is prioritizing the expansion of asynchronous care to improve patient access and convenience:
  • Definition: Patients interact with providers on their own schedule—via surveys, wearables, or messaging—instead of synchronous video or in-person visits.
  • Use Cases:
    • Acute care: E.g., young women with urinary tract infections can be treated efficiently without in-person or video visits.
    • Preventive care: Focused on HIV PrEP medication management.
    • Chronic care: Includes insulin and GLP1 titration management.
  • Quote:

    "Asynchronous care today is where telemedicine was in 2017." (Dr. Gavin, 03:38)

  • This innovation addresses access challenges for patients and streamlines care delivery for clinicians.

2. AI Governance and Assurance

[04:54] Girish Nadkarni

• Unified Governance: Mount Sinai created streamlined AI and digital health governance structures to enable rapid, responsible decision-making at the executive level.
  • Governance is categorized by personas: patient, clinician, workforce, researcher.
• AI Assurance Lab:
  • Established to ensure AI tools used in care are safe, effective, unbiased, and avoid "hallucinations."
  • Quote:

    "We set up also an AI assurance lab in order to make sure that AI is safe, effective, responsible." (Girish Nadkarni, 05:12)

• The overall goal is to ensure that AI empowers rather than obstructs clinical innovation.

3. Headwinds and Priorities for 2026

[06:28] Dr. Nicholas Gavin & [07:04] Girish Nadkarni

• Chief Concern: Loss of insurance coverage for many due to federal Medicaid rollbacks and ACA program changes.
• The health system is actively working to help patients maintain coverage and continuity of care.
• Quote:

  "The biggest headwind that we'll face going into this year." (Dr. Nicholas Gavin, 06:54)

4. Driving Access and Precision Matching

[07:52] Dr. Nicholas Gavin

• Access is the "holy grail" for Mount Sinai: More precise patient-provider matching via data and technology.
• Aiming to optimize specialty clinic utilization and align resources efficiently.
• Considering generative AI for identifying care gaps and optimizing matching.

5. Generative AI for Patient Interaction and Automation

[08:57] Girish Nadkarni

• Opportunities:
  • Patient-facing chatbots to proactively augment care at scale.
  • Automating routine admin tasks—preauthorization, insurance checks—to improve experience.
  • Quote:

    "...shift care from reactive to proactive at a scale that has never been done before." (Girish Nadkarni, 09:04)

6. Organizational Focus and Execution

[10:05] Dr. Nicholas Gavin

• Biggest Challenge:
  • Prioritizing execution on core organizational problems amidst a barrage of "shiny object" solutions from industry.
  • Staying focused on scalable, patient-centered initiatives rather than narrow point solutions.
  • Quote:

    "It's really, really important to focus on execution and focus on execution around core problems for the organization..." (Dr. Gavin, 10:13)

• [10:32] Girish Nadkarni:
  • Echoes importance of purpose-driven innovation: “Start with the why... keep the patients at the center of all of this.”

7. Organizational Growth and the Consumer-Driven Model

[11:28] Dr. Nicholas Gavin

• Mount Sinai aims to become the "most convenient health system" in New York City.
• Sees opportunity to lead as a truly consumer-oriented system, meeting patients on their terms—drawing on lessons from other industries.
• Quote:

  "No one has really stepped forward to say we are going to own being the most consumer oriented health system in New York City." (Dr. Gavin, 11:39)

8. Becoming a Learning Health System

[12:29] Girish Nadkarni

• Mount Sinai is leveraging data and continuous feedback to create a "virtuous cycle of learning, acting, doing, and further learning."
• Integration of consumer-orientation with learning from patient experiences to improve outcomes and experience.
• Quote:

  "The consumer oriented piece and the learning health system goes hand in hand because ultimately it's all about learning what we should do next and listening to patients and improving the experience." (Girish Nadkarni, 12:53)

Notable Quotes & Memorable Moments

• Dr. Nicholas Gavin [03:38]:
  "Asynchronous care today is where telemedicine was in 2017. The incentives aren't necessarily there yet, but we're starting to see patients adopt this type of care."
• Girish Nadkarni [05:12]:
  "We set up also an AI assurance lab in order to make sure that AI is safe, effective, responsible so that anything that gets deployed into clinical care is assured and made sure that we... There's no bias, there's no hallucinations, etc."
• Dr. Nicholas Gavin [10:13]:
  "It's really, really important to focus on execution and focus on execution around core problems for the organization as opposed to getting distracted by, by shiny objects in the periphery. That's going to be our challenge over the next year."
• Girish Nadkarni [12:53]:
  "The consumer oriented piece and the learning health system goes hand in hand because ultimately it's all about learning what we should do next and listening to patients and improving the experience."

Timestamps for Important Segments

• [01:14] – Guest introductions
• [02:24] – Expansion of asynchronous care
• [04:54] – AI and digital health governance structures, AI assurance lab
• [06:28] – Challenges with Medicaid and ACA policy shifts
• [07:52] – Leveraging data and technology to improve access and matching
• [08:57] – Role of generative AI in augmenting care and automating workflow
• [10:05] – Strategic focus: Prioritization and execution challenges
• [11:28] – Growth aspirations: Becoming consumer-oriented and a learning health system

Conclusion

Mount Sinai Health System is proactively confronting the dual challenges of digital transformation and rapidly changing healthcare policy. By expanding asynchronous care, implementing rigorous AI governance, and shifting toward a more consumer- and data-driven organizational mindset, Mount Sinai aims to deliver safer, more responsive, and accessible care. The conversation emphasizes the necessity of purposeful innovation and continuous learning to navigate industry disruption and better meet patient needs in the years ahead.