Becker’s Healthcare Podcast: Dr. Gregg Nicandri, Chief Medical Information Officer at University of Rochester Medical Center

Date: November 6, 2025
Host: Laura Dearda
Guest: Dr. Gregg Nicandri

Episode Overview

This episode features a conversation with Dr. Gregg Nicandri, Chief Medical Information Officer (CMIO) at the University of Rochester Medical Center (URMC). The discussion centers around digital transformation in healthcare, focusing on artificial intelligence (AI), virtual care, and the operational and regulatory challenges organizations face. Dr. Nicandri shares firsthand experiences, strategies for successful technology adoption, and advice for healthcare leaders facing rapid advances in tech and evolving regulatory landscapes.

Key Discussion Points and Insights

Introductions and Dr. Nicandri’s Background

• [01:00-01:46]
  • Dr. Nicandri serves as CMIO and is a practicing orthopedic surgeon.
  • He’s held the CMIO position at URMC for six years, overseeing technology to improve clinician experience.
  • “My main task is really to try to improve clinician experience through leveraging technology to optimize workflows and well-being.” – Dr. Nicandri [02:15]

Impactful AI Use Cases at URMC

• [02:15-03:20]
  • The most significant use case: Ambient documentation.
  • Large rollout: 1,000 licenses distributed, 75% active users among ambulatory clinicians.
  • Positive outcomes: Improved provider well-being, work-life balance (“work after work” measures), chart closure rates, and revenue.
  • “Ambient documentation has been revolutionary really for the group of providers... We've had really good outcomes across the board.” – Dr. Nicandri [02:25]

Navigating Innovation and Operational Constraints

• [03:50-05:11]
  • URMC’s motto: “Meliora,” meaning “ever better.”
  • Importance of recognizing the limited capacity for change and closely understanding end-user needs.
  • Successful technology rollouts require close collaboration with vendors and internal IT, directly addressing real problems clinicians face.
  • Example: The success of ambient documentation linked to clear pain point resolution and usability.
  • “People who are going to be using the technology actually see if it solves a problem for them. Obviously adoption is much higher...” – Dr. Nicandri [04:24]
  • Less successful rollouts occurred when usability or relevance was lacking.

Effective Change Management for Tech Adoption

• [05:39-07:27]
  • Let frontline clinicians and staff drive the strategy and rationale for technology adoption.
  • Avoid being vendor-driven; instead, ground solutions in actual organizational pain points.
  • Partnership with vendors and IT should follow internal needs assessment.
  • “Nobody knows our organization better than the people who work in it... staying close to them, understanding their pain points...” – Dr. Nicandri [05:48]
  • Critique of “shiny object syndrome” in digital health: Pilot solutions should be need-based, not trend-based.

Regulatory Environment and Operational Impact

• [07:27-09:57]
  • Recent state and federal regulatory changes (including a government shutdown) have compromised telehealth reimbursement, especially affecting Medicare/Medicare Advantage patients.
  • Successful virtual care, including hospital-at-home programs, forced to close due to regulation changes (e.g., reimbursement for home visits no longer valid).
  • “We were getting some really good results to the point that when we had to shut the doors... our major insurance partner contacted us and said, can you just keep that open for our patients?” – Dr. Nicandri [08:44]
  • Contingency planning is resource-intensive and adds operational strain.
  • “It's almost like you're doing... a third extra work because now you're having to come up with the solution based on the rules of today. But you've also got to think about a lot of what-ifs...” – Dr. Nicandri [09:57]

Advice for Healthcare Leaders Facing Tech Advancement and Growing Demands

• [10:24-11:54]
  • Stick to continuous improvement principles: facilitate agility, focus on well-being of clinicians and staff.
  • Engagement is key – well-being enables teams to adapt more readily.
  • Mission focus: Solve real problems for patients and providers rather than chasing new, trendy technologies.
  • “There’s a lot of things out there that you can do. ...Sometimes it’s hard to kind of not chase after the shiny object, but to really focus on those things that are important...” – Dr. Nicandri [11:33]

Notable Quotes & Memorable Moments

• “My main task is really to try to improve clinician experience through leveraging technology to optimize workflows and well-being.” – Dr. Nicandri [02:15]

• “Ambient documentation has been revolutionary... We've had really good outcomes across the board.” – Dr. Nicandri [02:25]

• “People who are going to be using the technology actually see if it solves a problem for them. Obviously adoption is much higher...” – Dr. Nicandri [04:24]

• “Nobody knows our organization better than the people who work in it... staying close to them, understanding their pain points...” – Dr. Nicandri [05:48]

• “It's almost like you're doing … a third extra work because now you're having to come up with the solution based on the rules of today.” – Dr. Nicandri [09:57]

• “There’s a lot of things out there that you can do. ...Sometimes it’s hard to kind of not chase after the shiny object, but to really focus on those things that are important...” – Dr. Nicandri [11:33]

Timestamps for Important Segments

• 01:00 – Dr. Nicandri introduces his role/background
• 02:15 – Impact of AI/ambient documentation at URMC
• 03:50 – Balancing innovation with operational reality
• 05:39 – Change management and adoption strategies
• 07:27 – Navigating new regulations and operational pivots
• 10:38 – Top advice for healthcare leaders

Overall Tone

The conversation is pragmatic, candid, and focused on practical leadership in the face of technology shifts and regulatory flux. Dr. Nicandri emphasizes grounded change, listening to frontline needs, and resisting the urge to implement tech just for the sake of innovation.

This episode offers valuable lessons for healthcare leaders navigating the evolving digital health landscape, underscored by firsthand insights and practical wisdom from a leader managing both clinical and technological transformation.