Podcast Summary

Becker’s Healthcare Podcast:

Guest: Roberta Schwartz, PhD, Executive Vice President and Chief Innovation Officer, Houston Methodist
Host: Scott Becker
Date: November 21, 2025

Episode Overview

In this insightful episode, Dr. Roberta Schwartz discusses the rapid evolution of innovation in healthcare, focusing particularly on technology adoption at Houston Methodist. She shares her experiences in transforming the system’s approach to AI, virtual care, and digital workflows while addressing challenges such as change management, the impact of reimbursement policies, and the risk of technological divides in healthcare. The conversation balances excitement for the future with the realities of implementation and access disparities.

Key Discussion Points & Insights

Dr. Schwartz’s Background and Role

• Career Journey (00:45):
  • 33 years in healthcare administration, experience ranging from consulting and CMS to executive leadership at Mount Sinai and now Houston Methodist.
  • At Houston Methodist: runs the large academic medical center (1,000 beds) and serves as Chief Innovation Officer for the whole 8-hospital system.

Acceleration of Healthcare Innovation

• Rapid Innovation Pace (02:05–04:54):
  • The maturation of technology is accelerating—comparing past changes to a "local train" and current advancements to a "bullet train."
  • Voice-to-text and ambient AI documentation are advancing so quickly that Dr. Schwartz is considering whether future hospital builds might no longer need in-room computers.
  • AI applications are expanding beyond documentation—camera-based monitoring in ORs, workflows to alert care teams, and sophisticated predictive analytics are described as “spectacular.”
  • "It’s...the speed of that maturation, the speed of where it's going from, ‘Oh, they can do one thing,’ ...to ‘They can do 20 things at one time, and they can do it insanely well.’” — Roberta Schwartz [03:50]

Technology’s Impact on Clinical Workflows

• Adoption and Cognitive Load (05:34–06:58):
  • Some innovations see initial resistance but are rapidly adopted (“two weeks to 60 days of pushback” for cameras/virtual nursing).
  • "If you're not asking for enormous amounts of change management and you're making that cognitive load less...they get adopted pretty quickly." — Roberta Schwartz [06:16]
  • Voice documentation is so popular among some physicians that, as Schwartz jokes, “You can pry this out of my cold, dead hands.” [05:56]
• Challenges in Virtual Care Uptake:
  • During COVID, 80–85% of visits were virtual; now it’s back down to 20%.
  • Dr. Schwartz attributes this mainly to doctors’ preference for in-person visits, not patient demand, noting resistance to virtual care in end-of-life or palliative scenarios.
  • "Unfortunately for me, it's like chipping away at a big wall with a plastic spoon. And I'd really like either a sledgehammer or a big pickaxe." — Roberta Schwartz [09:13]

Change Management and AI Triage

• Improving Virtual Care Selection (09:30–10:07):
  • Advocates for AI tools to help clinicians easily sort which patients should be seen virtually versus in-person (care traffic control).
  • Recognizes change management as a continual hurdle, exemplified by slow shifts in physician behavior and government regulation rollbacks risk further slowing progress.

Payment Policy and Innovation

• Government Reimbursement Concerns (10:07–13:16):
  • Payment rollbacks for telemedicine/hospital at home programs complicate innovation.
  • Emphasizes that payment models heavily influence adoption: “Everyone to a certain extent will follow the money… if that is available, then in an era where we have a shortage of supply of doctors and you want to maximize what doctors are able to do to say to them you can only do, you're only going to get paid if they come in person, that's a little harsh." [10:44]
  • Houston Methodist continues innovating even without guaranteed payment, but Dr. Schwartz worries about creating “haves and have-nots” in technology access.

Technology Access Disparities

• Digital Divide and the Two-Tier System (15:08–18:05):
  • The divide between systems that can afford advanced tech and those that cannot risks becoming entrenched; this mirrors wider disparities in care based on insurance status and socioeconomic factors.
  • Dr. Schwartz notes, “Almost every American has a cell phone. That means that access can be brought to them... But part of it starts with people believing, people maturing the technologies, people believing in these technologies, people doing the change management...” [15:13]
  • Centralized virtual care (“beaming” expertise from large centers) is key to supporting smaller or rural hospitals, but payment and belief in virtual models remain barriers.

The Future of Intelligent Healthcare

• Looking Ahead (18:53–21:43):
  • Dr. Schwartz reflects on the “revolution” in health tech happening within her career, excited for how large language models and AI will continue to shift the paradigm so “the information that we've got is starting to work for people rather than people working for putting in the information.” [19:35]
  • Houston Methodist is making “three-year bets” to predict and invest in technologies likely to mature soon, continuing its journey as a “smart hospital.”

Notable Quotes & Memorable Moments

• On the Explosion of Technology:
  “You moved from the local train to the Acela. You're now on a bullet train of development.” — Roberta Schwartz [02:16]

• On Adoption Among Clinicians:
  “You can pry this out of my cold, dead hands.” — Roberta Schwartz, quoting doctors on ambient voice, [05:56]

• On Telehealth Resistance:
  “It's like chipping away at a big wall with a plastic spoon. And I'd really like either a sledgehammer or a big pickaxe.” — Roberta Schwartz [09:13]

• On Payment and Access:
  “Everyone to a certain extent will follow the money...if that is available...” — Roberta Schwartz [10:44]

• On Intelligent Healthcare of the Future:
  “It's exciting to imagine a world where this does look very different than the one that we have today. We will still need doctors...but...the information that we've got is starting to work for people rather than people working for putting in the information...” — Roberta Schwartz [19:35]

Timestamps for Key Segments

• Dr. Schwartz’s Career & Background: [00:45–01:40]
• Innovation Acceleration at Houston Methodist: [02:05–04:54]
• Technology Adoption & Resistance: [05:34–06:58]
• Decline in Virtual Visits Post-COVID: [06:58–09:13]
• Change Management in Telehealth: [09:13–10:07]
• Government Payment Policies Impact: [10:07–13:16]
• Technological Divide & Equity: [15:08–18:05]
• AI, Smart Hospitals, and Future Trends: [18:53–21:43]

Summary Tone

The tone throughout is candid, optimistic, and pragmatic—Roberta Schwartz balances excitement about the future of healthcare technology with real-world considerations of access, reimbursement, and the challenge of driving organizational change.

This summary provides an engaging and comprehensive view of the episode, capturing key ideas, the spirit of the conversation, and Dr. Schwartz’s memorable insights.