Summary: Healthcare Upside Down — Lessons from Mayo Clinic and ECG on AI and Automation

Becker’s Healthcare Podcast | November 18, 2025
Guests: Edwina Boscorin (Mayo Clinic), Henry Stockman (ECG Management Consultants)
Host: Molly Gamble

Episode Overview

This episode of Healthcare Upside Down explores the current realities, challenges, and best practices for AI and automation adoption in healthcare, focusing on why so few pilots reach full-scale implementation. Host Molly Gamble is joined by Edwina Boscorin, Mayo Clinic’s Chief Clinical Systems and Informatics Officer, and Henry Stockman, Principal at ECG Management Consultants. Through their dialogue, listeners gain nuanced perspectives on technology integration, vendor management, risk, and organizational change in an industry being rapidly shaped by AI.

Key Discussion Points & Insights

1. What Makes AI Pilots Succeed or Fail?

(02:21–04:25)

• Context: Only 30% of AI pilots in healthcare reach full production.
• Edwina’s View: Sees the 30% as “both a positive and an opportunity.” It reflects innovation and deliberate selectivity.
• Insights on Success:
  • AI tools that integrate seamlessly with existing workflows or eliminate burdensome steps are more likely to succeed.
  • Sustained adoption at the 1- and 3-month marks is a strong indicator of long-term viability.
• Quote:

  “Those tools that can really create a new workflow or a new path and decommission something that they have worked on for years…helps a great deal.” — Edwina Boscorin [03:45]

2. Vendor Selection, Staying Power, and the Pace of Change

(04:51–06:58)

• Henry’s Perspective:
  • Healthcare systems are inundated with AI vendors; selecting the “winner” is challenging.
  • Many vendors may not survive the next 2 years.
  • It’s critical to partner with vendors capable of continuous innovation, not just a one-off solution.
  • Avoid betting everything on a single vendor – diversification and caution are key.
• Quote:

  “Probably 85% of these vendors are probably going to cease to exist in two years…Picking the right vendor and having that type of rigor I think is really important.” — Henry Stockman [06:15]

3. Practical Use Cases for AI, RPA, and Bots

(07:37–10:31)

• Henry’s Experience:

  • Many automation use cases aren’t truly new—AI is now bringing new attention and capabilities.
  • Most value today is in automating repeatable, rules-based tasks (e.g., low-dollar write-offs, portions of coding).
  • Risk: Over-automation can leave organizations exposed if vendors fail or needs change.
  • Caution: Take “baby steps” instead of wholesale restructuring.

• Edwina’s Mayo Clinic Experience:

  • Mayo has deployed 34 bots focused on automating stable, rule-based processes (e.g., eFax routing).
  • The focus is shifting towards clinical areas, but only where safety and rules-based logic are clear.

• Quotes:

  “RPA and bots is not a new thing. They just put AI in front of it so it became new again.” — Henry Stockman [07:41]
  “The processes that are most successful are those that are repeatable, those that have rules-based logic…and that are stable.” — Edwina Boscorin [11:06]

4. Achieving Long-Term Value from AI/Automation

(12:23–14:10)

• Both guests stress:
  • Sustainment—ensuring technologies continue to deliver value over time—is as important as innovation.
  • Strategic “decommissioning” of outdated tools is key to reallocating resources for newer, more impactful tech.
• Quote:

  “Make sure that organizations are relentless about decommissioning tools that no longer are useful…redeploy those resources…to sustain these technologies.” — Edwina Boscorin [13:30]

5. Organizational Barriers & the Speed of Change

(14:10–16:33)

• Henry: Healthcare entities are inherently challenged at decommissioning outdated technology due to classic constraints: time, people, and resources.
• Security is Top of Mind: Each new tech introduces risks related to data handling, model training, and vulnerability to bad actors.
• Quote:

  “There’s just a lot of other priorities…they don’t make decisions very quickly usually, which, there’s good reason for that.” — Henry Stockman [14:22]

6. Governance, Agility, and Foresight

(16:33–18:47)

• Edwina: It’s a “daily activity” to prioritize tech investments and decide what to retire.

  • Deeply ingrained workflows, passionate sponsors, and organizational inertia complicate decommissioning.
  • Transparent vendor communication about data usage and workflow impacts is essential for faster, more agile decision-making.
  • Assessing a technology’s anticipated evolution and the strength of vendor partnership is now part of every investment decision.

• Quote:

  “Historical governance processes…are being tested in a way that they haven’t been tested before.” — Edwina Boscorin [16:57]

7. Cautionary Note: The “Jurassic Park” Parallel

(19:23–20:37)

• Henry draws a pop-culture analogy (Jurassic Park), cautioning that healthcare is sometimes too focused on how to implement AI, without enough focus on if or where it should be applied.
• Quote:

  “We are so preoccupied trying to figure out how we can get this up and running…that we don’t too often sit back and go, should we do this and where should we do it?” — Henry Stockman [20:02]

Memorable Quotes

| Timestamp | Speaker | Quote | |-----------|---------|-------| | 03:45 | Edwina Boscorin | “Those tools that can really create a new workflow or a new path and decommission something that they have worked on for years…helps a great deal.” | | 06:15 | Henry Stockman | “Probably 85% of these vendors are probably going to cease to exist in two years…” | | 07:41 | Henry Stockman | “RPA and bots is not a new thing. They just put AI in front of it so it became new again.” | | 11:06 | Edwina Boscorin | “The processes that are most successful are those that are repeatable, those that have rules-based logic…and that are stable.” | | 13:30 | Edwina Boscorin | “Make sure that organizations are relentless about decommissioning tools that no longer are useful…” | | 14:22 | Henry Stockman | “They don’t make decisions very quickly usually, which, there’s good reason for that.” | | 16:57 | Edwina Boscorin | “Historical governance processes…are being tested in a way that they haven’t been tested before.” | | 20:02 | Henry Stockman | “We are so preoccupied trying to figure out how we can get this up and running…that we don’t too often sit back and go, should we do this and where should we do it?” |

Notable Themes and Takeaways

• Deliberate Selectivity: Low conversion from pilot to production isn’t failure, but a sign of thoughtful technological rigor.
• Integration Over Novelty: Seamless integration with workflows is more valuable than cutting-edge novelty disconnected from daily operations.
• Vendor Vigilance: The majority of AI vendors may not survive; prioritize those with a commitment to evolving alongside your needs.
• Sustainment & Decommissioning: Continual investments are needed in both supporting new tech and decisively retiring obsolete tools.
• Risk Perspective: Security, privacy, and operational disruption are ever-present risks amid breakneck innovation.
• Thoughtful Adoption: Sometimes, the critical question is not how, but whether, and where to apply technological solutions.

Important Timestamps

• 00:37–01:55: Guest introductions and backgrounds
• 02:21–04:25: Analysis of AI pilot failures/successes
• 04:51–06:58: Navigating AI vendor choices and market volatility
• 07:37–10:31: Effective use cases for AI, RPA, and automation
• 12:42–14:10: Keys to long-term value and the importance of tool decommissioning
• 14:17–16:33: Organizational barriers and security risks
• 16:33–18:47: Governance, agility, and adaptation
• 19:23–20:37: Final analogy and cautionary perspective

Tone

• Open, Candid, and Practical: Both guests emphasize real-world constraints and thoughtful progress over hype.
• Forward-Looking but Cautious: Recognition of rapid change and a call for measured, strategic action.

Final Thoughts

This episode is a candid exploration of the “upside down” logic often necessary for successful healthcare innovation. The guests encourage listeners to focus on lasting value and strategic agility, rather than being swept up by the hype surrounding emerging technologies. Both Mayo Clinic and ECG exemplify a blend of pragmatism, technical expertise, and organizational self-awareness—urging all healthcare leaders to ask not merely how, but why and to what end automation and AI should be adopted and sustained.