Becker’s Healthcare Podcast – Oct 30, 2025

Guest: Dr. Marcus Speaker, Associate Chief Medical Information Officer, Carilion Clinic
Host: Scott King, Becker's Healthcare

Episode Overview

This episode features Dr. Marcus Speaker from Carilion Clinic, focusing on the transformative impact of artificial intelligence (AI) in healthcare. Dr. Speaker shares practical insights from his extensive career in health IT and clinical informatics, highlighting real-world use cases for AI, strategies for technology adoption, and how evolving legislation and reimbursement trends influence healthcare IT decisions. The conversation is aimed at leaders navigating the intersection of innovation, governance, and sustainable patient care.

Key Discussion Points & Insights

Dr. Speaker’s Background and Role

• Career spanning nearly 20 years in healthcare IT and clinical informatics at Carilion Clinic.
• Board-certified in family medicine, with a fellowship and certification in informatics.
• Led EPIC implementation and optimization, clinical decision support, and most recently, the rollout of ambient scribe technology.
• (01:09) “I’ve been in healthcare IT now for close to 20 years…all the changes that have taken place over the past couple decades and now most recently have been leading our ambient scribe rollout across the organization.” – Dr. Marcus Speaker

Impactful AI Use Cases in Healthcare (02:40–06:52)

Clinician-Facing Innovations

• Ambient Scribe Technology:

  • Physicians can record patient conversations, which generates clinical notes automatically. This has significantly reduced after-hours documentation, improving work-life balance and efficiency.
    • (03:24) “I have physicians…telling me about how impactful the ambient scribe technology has been...getting their notes done on time, not having to work as much at night or on weekends.” – Dr. Marcus Speaker

• AI Augmented Patient Messaging:

  • Drafting responses to patient portal messages, improving efficiency and conversational tone in communication.
    • (04:10) “It helps with efficiency, in some cases, helps with tone, helps make those responses a little more pleasant and patient friendly.” – Dr. Marcus Speaker

• Generative AI for Note Summarization:

  • Quick, AI-generated overviews of a patient’s recent health history, with the ability to drill down into source documentation as needed.
    • (04:45) “Being able to pull up a patient chart…see a summary of everything that has taken place…gives me the ability to…get all those really important points.” – Dr. Marcus Speaker

Backend and Administrative Use

• Generative AI for Business Applications:
  • Assists with project planning, patient education material creation, and tailoring content to specific literacy levels.
    • (05:25) “Our application analysts…project managers, all using generative AI to help put together project plans, craft emails, help craft patient education…rewrite that at a sixth grade level.” – Dr. Marcus Speaker

Navigating AI Adoption: Governance & Operational Strategy (07:49–09:49)

• Governance is Crucial:
  • Multidisciplinary teams with deep technical understanding of AI are essential for effective oversight.
• Focus on Real Problems:
  • Cautioned against adopting “shiny new” tech that doesn’t solve an existing pain point.
    • (08:46) “Organizations are looking for solutions to problems that they have…not addressing a problem that we currently have…rather than putting in the new and bright shiny piece.” – Dr. Marcus Speaker
• Engagement with Vendors:
  • Importance of carefully vetting vendors and technologies to align with organizational needs.

Legislative and Regulatory Pressures (10:07–12:23)

• Primary Concern: Reimbursement Models
  • Carilion has a large Medicare and Medicaid population; shifts in reimbursement particularly affect their IT strategies.
  • Active review of legacy and third-party IT systems, preferring consolidation into core systems (like Epic) for efficiency and cost savings.
    • (10:48) “We have recently determined that we could, with our core systems, do maybe 80 to 90% of what the…third party system can do. And so we’re looking at moving away from some of these third party systems…which results in savings and puts us in a better place as we look to weather some of the headwinds.” – Dr. Marcus Speaker
• Telehealth Reimbursement:
  • Close monitoring of policy changes, aiming to protect financial margins in a shifting regulatory landscape.

Advice to Healthcare Leaders (12:44–13:36)

• Anchor Technology Adoption in Strategy
  • Reiterate need to align technology investments with real organizational goals and problems—not just what’s trending.
    • (12:54) “Make sure that you’re focused on your…organization’s strategy, understanding what your problems and your goals are, and then layering in the appropriate technology…align with core strategy.” – Dr. Marcus Speaker

Notable Quotes

• (03:24) “Ambient scribe technology…has been the first major positive game changer, I think, for our physicians in a long time.” – Dr. Marcus Speaker
• (04:10) “It helps with efficiency, in some cases, helps with tone, helps make those responses a little more pleasant and patient friendly.” – Dr. Marcus Speaker
• (05:25) “Our project managers, all using generative AI to help put together project plans…rewrite that at a sixth grade level…” – Dr. Marcus Speaker
• (08:46) “Really trying to figure out what problems are you trying to solve…rather than putting in the new and bright shiny piece?” – Dr. Marcus Speaker

Timestamps for Key Segments

• Intro & Guest Background – 00:43–02:12
• AI Use Cases in Practice – 02:40–06:52
• Governance and Adopting New Tech – 07:49–09:49
• Legislative/Policy Impacts – 10:07–12:23
• Advice to Leaders – 12:44–13:36

This episode offers a practical, systems-oriented view on the adoption and governance of AI and digital technology in healthcare, emphasizing thoughtful alignment with organizational needs and regulatory realities. Dr. Speaker’s hands-on perspectives provide valuable guidance for any healthcare leader considering the next steps in their digital journey.