Becker’s Healthcare Podcast

Guest: Bob Berbeco, Chief Information Officer at Mahaska Health
Host: Laura Deardo
Date: October 24, 2025

Episode Overview

This episode features Bob Berbeco, CIO at Mahaska Health, a critical access hospital in rural Iowa. The conversation dives into leveraging technology and AI to improve both clinical and operational efficiency, practical strategies for balancing innovation with constraints, navigating recent healthcare legislation, and actionable advice for healthcare leaders facing rapid technological evolution—all with a strong focus on rural healthcare’s unique needs.

1. Introduction and Bob’s Background (00:44 – 03:31)

• Bob Berbeco’s Journey:
  • Over 27 years in healthcare technology and operational leadership.
  • Extensive experience in data science, AI, cybersecurity, Six Sigma-based process improvement, change management, and mentoring.
  • Active within arts and academic communities; Board member at Indianapolis Ballet and IU School of Science; recipient of a Distinguished Alumni Award.
• Personal Mission:
  • "I love mentoring emerging talent and I look to make a daily positive impact in healthcare and beyond." (02:19, Bob Berbeco)

2. About Mahaska Health & Current Initiatives (03:31 – 04:54)

• Critical Access Hospital Focus:

  • Serving rural Iowa since 1910/1912; committed to community health and continuous growth.
  • Expanding outpatient services; leveraging technology to enhance both patient and provider experience.

• Digital Transformation Projects:

  • Artificial intelligence (AI) and EMR optimization
  • Workflow and process optimization, aiming at tangible benefits for both staff and patients.

3. AI in Practice: Focus Areas and Adoption (04:54 – 08:34)

• Three Pillars of AI Impact:

  1. Ambient Clinical Documentation
     • Use of “MD Hub,” an AI scribe tool, reducing physician burnout and after-hours charting.
     • “It’s reduced burnout and after hours starting.” (05:28, Bob Berbeco)
  2. Operational/Revenue Cycle
     • AI copilots improve billing/denial prediction, appeal drafting, coding, inbox triage; all approached as incremental improvements.
  3. Care Access & Patient Experience
     • Dashboards to track and reduce no-shows; personalized outreach via Epic/MyChart; AI-driven patient routing to appropriate care sites.

• EMR Integration & AI Roadmap:

  • Commitment to leveraging Epic’s Community Connect platform via UnityPoint Health as host.
  • Open to third-party AI “bolt-ons” where they offer value beyond Epic's built-in features.
  • Adopting Epic’s evolving AI functions as they become available.

• Strategic Approach:

  • “We’re prioritizing AI to remove administrative friction, to protect clinical time, and look to improve safety and experience.” (07:43, Bob Berbeco)
  • Emphasis on measurement, adaptive change management, and pragmatic tech evaluation.

4. Innovation vs. Operational Constraints: Playbooks for Balancing Both (08:34 – 12:50)

• Managing Demand vs. Resources:
  • “The biggest challenge that I face today is managing that large amount of demand…within the constraints of finance resources.” (09:16, Bob Berbeco)
  • Three-pronged leadership approach:
    1. Provider Engagement by Default:
       • Clinician voices prioritized; “go in with a beginner’s mind—no assumptions”; identify champions, validate workflows, prioritize usability.
    2. Clear Governance:
       • Defined accountabilities and playbooks; set expectations and communication pathways before beginning projects.
    3. Tiered Demand Management:
       • Two work streams:
         a. “High lift” with more checks for costly/risky projects.
         b. “Demand management light” for low-risk, agile initiatives—enabling quick wins or rapid failure.
       • “The overall goal…is you’ll find that business value as quickly as possible…do it with minimum waste.” (11:57, Bob Berbeco)

5. Navigating Legislation & Cybersecurity (12:50 – 18:13)

• Responding to Regulatory Changes:

  • Relies on Epic’s compliance updates (via UnityPoint Health) to address evolving federal/state rules, especially as a resource-constrained rural provider.
  • Example:
    • TEFCA (Trusted Exchange Framework and Common Agreement)—now live via Epic Nexus, enabling easy, nationwide health information exchange.
    • Maintains compliance with interoperability and price transparency mandates via Epic and proactive validation of public-facing data.

• Cybersecurity as a Continuous, Inclusive Priority:

  • “Cybersecurity…is something that is a huge focus…there’s big repercussions if you’re not doing what you should be doing.” (15:51, Bob Berbeco)
  • Mapped security controls to HHS’s healthcare performance goals; ongoing risk assessments, penetration tests, and full-team incident rehearsal.
  • Heavy emphasis on education and awareness, focusing on “growing [team members’] awareness and resistance to the socially engineered attempts…to gain access to our systems.” (17:57, Bob Berbeco)

6. Advice for Healthcare Leaders (18:13 – 20:07)

• Be Disciplined with Foundations, Bold with Outcomes:
  • “Be disciplined about the architectural plumbing and the foundations, and be bold about the outcomes.” (18:40, Bob Berbeco)
  • Invest in strong architectures, data foundations, and business needs analysis upfront.
  • Set up Centers of Excellence, e.g., for data science / AI—ensure repeatable, ethical, value-driven projects.
  • Run a structured, ever-improving playbook—a Six Sigma “A3” approach, mapping problems, causes, future states, and results; “adapt as you’re learning.”
  • “You can adapt as you’re learning and then you’ll have some quick wins, test solutions, do it lightweight, track those results closely.” (19:55, Bob Berbeco)

7. Notable Quotes

• “I love mentoring emerging talent and just every day I look to make a positive impact within healthcare and beyond.” (02:21, Bob Berbeco)
• “We’re prioritizing AI to remove administrative friction, to protect clinical time, the clinician’s time, and look to improve safety and experience.” (07:43, Bob Berbeco)
• “The overall goal of that process is you’ll find that business value as quickly as possible…do it with minimum waste.” (11:57, Bob Berbeco)
• “Cybersecurity…is something that is a huge focus…we are continually reviewing and looking at our cybersecurity program to make sure that we’re meeting all additional best practices.” (15:51, Bob Berbeco)
• “Be disciplined about the architectural plumbing and the foundations, and be bold about the outcomes.” (18:40, Bob Berbeco)

8. Key Timestamps

• 00:44: Introduction & Bob’s background
• 03:31: About Mahaska Health’s mission and current digital initiatives
• 05:13: Where AI is impacting Mahaska Health’s operations
• 08:34: Strategies for adopting technology amidst resource constraints
• 12:50: Adjusting to legislative and regulatory changes
• 15:50: Cybersecurity priorities & best practices
• 18:37: Top advice for health leaders on tech and care advances

Conclusion

This episode offers deep insights into how rural hospitals like Mahaska Health can strategically harness technology and AI, balance innovation with operational reality, and lead with strong governance and best practices. Berbeco emphasizes the importance of pragmatic leadership, listening to the front lines, disciplined change management, and continual improvement—all essential for healthcare organizations in today’s rapidly evolving environment.