Summary5 min read

Becker’s Healthcare Podcast: Kathleen Fear, Senior Director, Digital Health & AI at University of Rochester Medical Center

Date: November 11, 2025
Host: Chanel Bunger
Guest: Kathleen Fear

Episode Overview

This episode features Kathleen Fear, Senior Director of Digital Health and AI at the University of Rochester Medical Center, recorded live at the 10th annual Health IT Digital Health and RCM Meeting in Chicago. The discussion centers on the practical implementation and strategy of AI within a healthcare system, balancing innovation with operational and regulatory realities, and advice for industry leaders navigating a rapidly evolving technological landscape.

Key Discussion Points & Insights

1. Kathleen Fear’s Role and Scope [00:47 – 01:32]

Kathleen describes her role as overseeing strategic AI initiatives, from deploying an enterprise AI platform to tool development and policy creation.
She leads the data science team within the medical center’s innovation group, balancing hands-on technical work with higher-level strategy and governance.

“It’s a really fun balance of kind of hands on, like boots on the ground kind of work, as well as doing some of the higher level strategic and policy pieces as well.”
— Kathleen Fear [01:20]

2. Real-World Use Cases for AI in Healthcare [01:32 – 03:53]

Kathleen segments use cases into two categories:
- Quantifiable Strategic Initiatives:
  - Emphasis on projects with clear return on investment (ROI), such as:
    - Patient access improvements (e.g., enhanced scheduling)
    - Denials management
    - Identifying care gaps
- General-Purpose Workflow Enhancement:
  - Many micro-improvements that boost everyday efficiency, often too minor to warrant vendor investment.
  - Use of customizable AI tools (e.g., chatbots) for tailored, locally impactful solutions.

“Many of the AI projects that we’ve pursued are really focused in on those areas. So things like support for better scheduling, denials management, identifying care gaps in our patients, those kinds of things.”
— Kathleen Fear [02:19]

“These things really have the potential to empower people to take charge of their own work, to build and implement things on a very local scale that really make a difference for them in the work that they’re doing day to day.”
— Kathleen Fear [03:29]

3. Balancing Innovation with Operational Constraints [03:53 – 05:40]

Innovation and constraints are not opposites—limits often spur creativity.
The team focuses on “non-obvious” solutions, tailoring systems that offer unique value not addressed by major vendors.
Competition and industry trends require careful focus on organization-specific needs.

“Constraints can in many cases be the spark for better innovation.”
— Kathleen Fear [04:23]

“We have to really focus in on the things that are going to be meaningful for our health system that we can build, that we’re probably not going to find elsewhere, and things that we can really make an impact from locally.”
— Kathleen Fear [05:17]

4. Navigating Shifting Legislation and Regulations [05:40 – 08:19]

The current regulatory environment is described as “uncertain,” but strong ethical foundations provide stability.
Focus is on resilience: building relationships (especially with in-house legal counsel and vendors) to adapt quickly when laws or regulations change.
Example: New York State’s chatbot regulation regarding self-harm detection was quickly implemented in their generative AI tools via vendor collaboration.

“I think our health system and others that I’ve seen, we’ll just continue down the path of doing the right thing, no matter what the regulatory or legislative environment sort of comes up with as we go along.”
— Kathleen Fear [06:41]

“At about the time that we were implementing [a generative AI chatbot], New York State started requiring that chat bots detect if a user says something indicating intent to self harm and respond by providing resources…we were able to go back to our vendor and…they were able to implement what we needed, you know, over the course of basically a couple days or a weekend.”
— Kathleen Fear [07:25]

5. Advice for Healthcare Leaders Facing Technological Change [08:19 – End]

Kathleen advocates for leaders to stay optimistic and embrace excitement, balancing caution with forward-looking positivity.
She highlights that the current period is “transformative” for healthcare technology.

“I think the main piece of advice that I have for other leaders is to, like, stay excited about all this…If we can approach this moment that we’re in with kind of excitement and balance, optimism, we can really go far.”
— Kathleen Fear [08:34]

“We’re at a transformative moment in healthcare, and I think our leaders will go the farthest, do the most, do the best if we can keep an eye on what’s positive now and aim towards that.”
— Kathleen Fear [08:54]

Notable Quotes & Memorable Moments

On constraints sparking innovation:
“Constraints can in many cases be the spark for better innovation.” [04:23]
On proactive compliance and adaptation:
“We’re traveling down the path that we think is the right thing to do, but also sort of staying aware of the broader environment and trying to make sure that we’re prepared to respond when we need to.” [08:09]
Final advice for leaders:
“Stay excited about all this…We're at a transformative moment in healthcare, and…I think our leaders will go the farthest, do the most, do the best if we can keep an eye on what's positive now and aim towards that.” [08:34, 08:54]

Key Timestamps

[00:47] Kathleen’s background & URMC AI initiatives
[01:52] Two categories of impactful AI use cases
[03:53] Reconciling innovation with operational limitations
[05:40] Impact of legislation and regulatory shifts
[06:50] Chatbot adaptation to state regulation (self-harm detection)
[08:32] Kathleen’s top advice for healthcare leaders and closing thoughts

Summary

Kathleen Fear provides a grounded, strategic perspective on deploying AI and digital innovation in healthcare, emphasizing a practical balance between ambition and operational reality. She urges leaders to remain both prepared and optimistic, leveraging both industry constraints and evolving regulations to drive meaningful, responsible progress. The episode is rich with actionable insight, particularly for those navigating digital transformation within large-scale health systems.

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Transcript15 lines

[00:01]
A
Philips is a health tech leader focused on innovation that improves the health and well being of people. Our healthcare technology and informatics solutions help care teams diagnose, treat and manage more patients with greater precision, speed and confidence. Across the care journey with Philips, clinicians are empowered with streamlined insights in the moments that matter for every patient. Better care for more people. Philips.
[00:29]
B
Hello and welcome to the Becker's Healthcare Podcast. My name is Chanel Bunger and today I'm recording live at the 10th annual Health IT Digital Health and RCM Meeting in Chicago and currently sitting down with Kathleen Fear, the Senior Director of Digital Health and AI at the University of Rochester Medical Center. Kathleen, thank you so much for joining me today.
[00:46]
C
Yeah, thank you so much for having me.
[00:48]
B
Perfect. Well, to get us started, could you share a bit about yourself and your work in healthcare?
[00:51]
C
Sure. So I'm the Senior Director of Digital Health and AI for the University of Rochester Medical center and I also lead our data science team within our innovation group. So in my role, you know, I'm lucky enough to get to be involved in all of your MC's strategic AI initiatives. You know, from rolling out our enterprise AI platform, to building and implementing tools, to working through, you know, our governance and policy development pieces of things. So it's a really fun balance of kind of hands on, like boots on the ground kind of work, as well as doing some of the higher level strategic and policy pieces as well.
[01:32]
B
Got it, got it. Thank you so much for that introduction. And we all know that is a huge buzzword. It's literally in your title with that. And nearly half of all medical practices reported using AI in some capacity last year. I'm curious, from your perspective though, what are some use cases that are making a difference for you and your organization right now and how are you leveraging them?
[01:53]
C
Yeah, so I tend to think of the use cases that we're looking at in sort of two big categories. So one is use cases where we expect to be able to make a meaningful, measurable impact on things that are strategically important to us. And so for us, those are things like roi, you know, we need to make more money or save money. And for us, a major priority is improvements in patient access. So many of the AI projects that we've pursued are really focused in on those areas. So things like support for better scheduling, denials, management, identifying care gaps in our patients, those kinds of things. Those are the things that we think that we can implement, do a good job of, and be able to sort of track and measure our success with those things. The Second category of use cases that I think are important, but the ROI is maybe a little harder to quantify our use cases that really depend on kind of general purpose AI tools. So one of the things that we know about how work happens in our organization is that there are a lot of little things we all have to do every day that are inefficient or annoying or really good opportunities for streamlining and improving things. But many of those are little things that like, might make a difference to me, but it's never going to be a big enough use case that it makes sense for us to like seek out a vendor for a product or build something to release to the organization. And so that's where we see a lot of opportunity for things like, you know, we've deployed a general AI chatbot and the ability for people to build kind of custom assistance for themselves. These things really have the potential to empower people to take charge of their own work, to build and implement things on a very local scale that really make a difference for them in the work that they're doing day to day.
[03:53]
B
Absolutely. And now moving forward, as virtual care expands from AI enabled tools and remote monitoring to broader digital health platforms, introducing technology can always be challenging. With that, what advice do you have for other healthcare leaders? Navigating everything from governments to patient engagement? And can you share an example of how your organization has balanced innovation with operational constraints?
[04:17]
C
Yeah, so I think it's important to kind of consider that innovation and operational constraints aren't necessarily at odds with each other, and constraints can in many cases be the spark for better innovation. You know, there's, there's a quote from, I think Jeff Bezos about that. Like, one of the only ways to get yourself out of a tight spot is to invent your way out. I mean, in healthcare we're always going to face constraints. There are always going to be budgetary and operational and bigger picture kinds of constraints that we have to work around. But if we can design with those things in mind, I think we end up with solutions that are not only more creative, but are more trustworthy, more safe, more responsible. One of the places that we run up against this a lot, working specifically in an innovation group, is we are constantly having to consider what the rest of the market is doing. You know, we don't want to build something that EPIC comes along and does the next day. And so when dealing with that constraint, I think the positive thing about it is that it's led us to really consider the use cases that are not sort of the Big obvious things that every vendor is going to go for. We have to really focus in on the things that are going to be meaningful for our health system that we can build, that we're probably not going to find elsewhere, and things that we can really make an impact from locally.
[05:41]
B
Absolutely, absolutely. And now as of this recording, it's currently October 1st, and so there's a lot of things going on on the legislation side with the government shutdown right now and then hospital at home being up in the air. And I'm just curious to know, how are you seeing recent legislation, both state and federal, affect healthcare organizations and healthcare IT specifically, And have you adjusted strategies in response?
[06:05]
C
Yeah. So, you know, I think it's fair to say that the regulatory and legislative environment is uncertain, you know, but I think in some ways that has less of an impact on health systems than, than it could because we, I think, have always taken really seriously our responsibility to build and implement AI systems that are trustworthy and that take care of our patients, take care of our staff, that, you know, we're doing our work in this space in ways that are responsible and transparent and ethical and all these things. And so, you know, I think our health system and others that I've seen, we'll just continue down the path of doing the right thing, no matter what the regulatory or legislative environment sort of comes up with as we go along. I do think one of the, one of the things that we have tried to do is really focus on kind of building our relationships, both internal and external, so that we're prepared if something does get thrown at us. So, you know, I personally have been working with our Office of Counsel much more than I ever have in my career because they're staying on top of everything that might be coming our way. And we've also tried to make sure that when we're partnering with vendors that if something gets thrown at us, that they're prepared to help us pivot quickly. So for an example of this, you know, I mentioned that we implemented kind of a generative AI chatbot. And at about the time that we were implementing that, New York State started requiring that chat bots detect if a user says something indicating intent to self harm and respond by providing resources. You know, that it had to be a pretty specific way that the chatbot responded. And we were able to go back to our vendor and say, hey, this is, this is what's happening. This is what we need the tool to be able to do. And they were able to implement what we needed, you know, over the course of basically a couple days or a weekend. So I think for us, like I said, we're traveling down the path that we think is the right thing to do, but also sort of staying aware of the broader environment and trying to make sure that we're prepared to respond when we need to in the ways that we need to.
[08:20]
B
Absolutely. Well, Kathleen, I want to thank you for your time today, but before I let you go, I'm curious to hear what's your top piece of advice for other healthcare leaders as they prepare for further advancements in technology and raising demands for care?
[08:32]
C
Yeah, I think the main piece of advice that I have for other leaders is to, like, stay excited about all this. You know, I think it's really easy for us all to get really bogged down in, like, thinking about risk and uncertainty and constraints and how we're going to get all this stuff done. But I think if we can approach this moment that we're in with kind of excitement and balance, optimism, we can really go far. We're at a transformative moment in healthcare, and I think our leaders will go the farthest, do the most, do the best. If we can keep an eye on what's positive now and aim towards that.
[09:18]
B
Well, that's a great place to end it. Kathleen, I want to thank you once again for your time today and for sharing your insights of the Becker's Healthcare podcast.
[09:23]
C
Yeah, thank you so much.