Scaling AI in Healthcare with Governance, Trust, and Impact at City of Hope

Summary

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Podcast Summary

Becker’s Healthcare Podcast

Episode: Scaling AI in Healthcare with Governance, Trust, and Impact at City of Hope

Date: March 21, 2026
Guests:

• Simon Nazarian, Executive Vice President and Chief Digital Technology Officer, City of Hope
• Nassim Eftikari, Chief AI and Analytics Officer, City of Hope
  Host: Laura Dearda

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Episode Overview

In this episode, Laura Dearda sits down with Simon Nazarian and Nassim Eftikari to explore how City of Hope is scaling AI in healthcare. The conversation centers on the organization's approach to governance, building trust, and creating impact with AI—emphasizing responsible adoption, organizational education, and future growth opportunities.

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Key Discussion Points & Insights

1. City of Hope Overview and Digital Transformation

[00:41 – 02:40]

• Simon Nazarian introduces City of Hope’s legacy and national reach as a top-tier, multi-site cancer center.
• The organization oversees technologies that enable care at scale, ensuring innovations are operationalized rather than stalled at the pilot stage.
  • “We want to make sure that we build durable infrastructure and just not one-off pilots that don't scale.” – Simon Nazarian [02:20]

2. Defining and Embedding AI Governance

[03:26 – 06:22]

• Governance as an Enabler:
  • Rather than policing, governance structures empower teams and clarify decision rights. It’s designed to be intrinsic, not an external control.
  • “Reframing our governance as an enabler, not a barrier … as a partner, not a police.” – Simon Nazarian [03:44]
• Orchestrating Tools and Agents:
  • City of Hope is proactively addressing the challenge of fragmented AI tools ('AI agents'). They aim to manage these agents holistically to prevent bottlenecks and optimize system-wide processes.
  • “How do we manage all these AI agents and tools...orchestrate them to work effectively with one another and optimize the whole system?” – Nassim Eftikari [05:14]

3. Priorities & Headwinds for the Next Year

[06:59 – 10:02]

• Empowering Agency Across the Organization:
  • The focus is on equipping clinicians and researchers to responsibly use and even build AI tools themselves.
  • “Innovation is federated...we have to rethink the decision rights when we scale this agency.” – Simon Nazarian [07:33]
• AI Fluency and Education:
  • With rapidly democratized AI, a major initiative is extensive workforce education to ensure safe, effective, and compliant usage.
  • “AI literacy, fluency, education…so that people know if you're using this AI tool...when you put something in it, it goes on the cloud.” – Nassim Eftikari [08:38]
• Ongoing efforts span outreach, training, and creating enterprise-safe AI tools.

4. The Hardest Challenge: Change Management and Adoption

[10:37 – 12:46]

• The biggest recurring barrier is change management and cultural adoption—not technology itself.
  • “The hardest thing has always been...change management, adoption, changing the culture so that these tools make the intended impact.” – Nassim Eftikari [10:39]
• Ensuring AI reduces (not adds to) teams’ burden is a core aim; moving from a “tech-enabled” to a “tech-forward” culture requires new norms, clarity, and organizational trust.
  • “Success depends on trust, clarity, and the champions across the organization. This is not something you mandate.” – Simon Nazarian [12:26]

5. Opportunities for Organizational Growth

[13:26 – 15:39]

• Blended Intelligence:
  • The future is about combining AI with human wisdom, decision-making, and empathy—AI as an amplifier, not a replacement.
  • “AI really has the capability to amplify human wisdom, not to replace it.” – Simon Nazarian [13:43]
• Invisible Innovation:
  • True innovation should be seamless, letting clinicians focus on care (“top of their license”) and patients experience the best possible care.
• Expanding Patient Access:
  • Technology—and specifically AI—extends City of Hope’s reach, making world-class care and research accessible even beyond their core centers.
  • “In every community center, even outside of City of Hope, people can have access through our technology to the world-class care and research that we provide.” – Nassim Eftikari [15:04]

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Notable Quotes & Moments

• On Governance:

  • “We have a very strong focus on governance and our operating model when it comes to advanced and emerging technologies.”
    – Simon Nazarian [03:27]

• On Orchestrating AI Tools:

  • “…in a year or so we don't have tens, hundreds, thousands of agents running around the organization, each doing their own thing and they cannot talk to each other.”
    – Nassim Eftikari [05:01]

• On Education and Safety:

  • “We had to hug AI close for some time and started educating, educating, educating so that people know…you don't put PHI into these publicly available tools.”
    – Nassim Eftikari [08:51]

• On Change Management:

  • “Onboarding AI tools always requires a lot of changes to people's day to days and workflows. And we're talking about people who are already extremely busy and a lot of time set in their own ways.”
    – Nassim Eftikari [11:10]

• On Blended Intelligence:

  • “To bring the best knowledge to the point of decisioning and letting our human wisdom apply the context, values and the judgment at that point.”
    – Simon Nazarian [13:31]

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Important Timestamps

• 00:41 – 02:40: City of Hope’s scale, mission, and digital platform leadership
• 03:26 – 06:22: AI governance philosophy and orchestration challenge
• 06:59 – 10:02: Scaling responsible AI agency, AI education across the workforce
• 10:37 – 12:46: Tackling organizational change and fostering a culture of trust and adoption
• 13:26 – 15:39: Growth opportunities: blended intelligence and expanding patient access

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Tone and Language

Both Simon and Nassim approach the topics with humility, clarity, and a deep sense of responsibility—emphasizing partnership, continuous learning, and patient-centric values. They underscore the need for transparent communication, iterative governance, and cultural alignment to ensure AI delivers real, equitable value in healthcare.

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For Listeners: Key Takeaways

• Scaling AI in a complex healthcare system requires strong but enabling governance.
• The real challenge is not the technology, but education, cultural change, and trust.
• City of Hope’s strategy emphasizes federated innovation, AI fluency, and seamless, patient-centered impact.
• The future is about blending human expertise with AI augmentation—keeping clinical wisdom at the heart of care.

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Transcript

[A]

This is Laura Dearda with the Beckers Healthcare podcast. I'm thrilled today to be joined by Simon Nazarian, Executive Vice President and Chief Digital Technology Officer at City of Hope. Nassim Eftikari, who is the Chief AI and Analytics Officer at City of Hope. Nassim, Simon, thank you so much for joining us on the podcast today.

[B]

Happy to be here.

[C]

Great. Thanks for having us.

[A]

Fantastic. Well, I'm looking forward to learning more about everything you're doing at City of Hope. I know it's a fantastic organization, really innovative and on the cutting edge of what's happening in cancer care today and more. So I'm excited to dig in. But before we do, can you tell me a little bit more about yourself? Give us a bit of your backgrounds and then a little bit about Sea of Hope too.

[C]

Fantastic. I can start. Hi, my name is Simon Nazarian and I'm the Executive Vice President and Chief Digital and Technology Officer for City of Hope. And you know, it's an exciting role we're playing today. Especially since City of Hope was founded in 1913, we've been focused on providing compassionate care to people in need. We really focus on what's best for our patients and that guides everything that we do. In the past several years, City of Hope has experienced tremendous growth. We are one of the largest and most advanced cancer research and treatment organizations in the US and ranked among the nation's top cancer centers in the U.S. we're very proud of that in a City of Hope's NCI designated Comprehensive Cancer center received the highest rating from the nci and that puts US City of Hope in the top echelon of the nation's 57 NCI designated comprehensive cancer Centers. We are system wide, so we are in five major metropolitan areas including LA, Orange County, Chicago, Atlanta and Phoenix. And 86 million people live in communities with close access to one of our facilities. And in my role, I oversee digital technology, enterprise platforms that really support care at scale. So anything that has to do with technology rolls up to my organization and in partnership with Nassim, really focused on how innovation actually moves from idea to adoption in a very complex health system. We want to make sure that we build durable infrastructure and just not one off pilots that don't scale.

[B]

Thank you Simon for that great introduction of City of Hope. I'm Nassim Chief AI and Analytics Officer. I lead meaningful application of machine learning AI under Simon's leadership in all areas of patient care, research, precision medicine and operations. I've been with the company for nine years now and my background is in computer science and machine learning.

[A]

That's amazing to hear and really great to have that experience at City of Hope and then be able to support its growth, which has been outstanding over the last several years. I'm curious, could you tell me a little bit more about the most important initiative that you've led in the last year or so? What did you do and what were the results?

[C]

Well, I would say that we have a very strong focus on governance and our operating model when it comes to advanced and emerging technologies. So the most important initiative wasn't just a single tool. It was really establishing the conditions for AI to scale responsibly within our organizations and really focusing on reframing our governance as an enabler, not a barrier. So I would dare say as a partner, not a police. So, you know, help clarify decision rights, you know, embedding the right guardrails and really moving governance closer to where the work is actually happening. So this is not a bolt on anymore for us. It's within the structure of our organization and we want to make sure that we do the right things for our folks and really focus on scale and velocity and really partner with our organization. Nassim, anything you want to add?

[B]

Sure. I want to add a little bit to the governance piece we've been giving a lot of thought to. How do we safely and responsibly apply these technologies, but also balance the speed of innovation, like Simon said, with safe and responsible use of AI? We have had a lot of like, very tangible, exciting initiatives that we've been leading over the past year, like using generative AI for patient onboarding, for clinical trial matching, and many other things in digital pathology, in precision medicine and others. But one of the most important things that I keep thinking about day in, day out is, and it ties into governance a little bit and scale and velocity is how do we really orchestrate all of these different AI tools and these days AI agents that every organization is adopting for point solutions. So you want to get ahead of it so that in a year or so we don't have tens, hundreds, thousands of agents running around the organization, each doing their own thing and they cannot talk to each other. So I think in terms of governance and also technology, a big top of mind for me is now how do we manage all these AI agents and tools, not just agents, but AI tools and agents. How do we orchestrate them to work effectively with one another and optimize the whole system rather than just one part of a local optimization of we solve this problem, but then we shift the bottleneck somewhere else and then we have to solve that other problem.

[A]

That makes a lot of sense. It is truly fascinating to see all of the different possibilities that are out there with AI. But you're right, being able to have the governance process and having visibility into everything that's going on, the different agents and sharing that with the entire organization so you can smartly and effectively incorporate AI without too much risk coming back to you. I think that's critical and so helpful to understand that process that you've taken and really built into what you're doing at City of Hope now. Looking ahead for the next year or so, where are some of your big priorities and headwinds that you're focused on? What's really top of mind for you?

[C]

Oh man, a fantastic question. I think NASSIM really hit it. A major priority is scaling agency across the organization responsibly. It's really important for us to empower our researchers, our clinicians and our teams to be able to create and run their own agents right? You know, for them to be trained and skilled, to act with confidence, to, you know, use all of our intelligent tools responsibly and make decisions closer to the work. And you know, one of my mantras at the office here is that innovation is federated and we believe that this really will help us make that come true because we have to rethink the decision rights when we scale this agency and not just deploying a basic technologies. The headwind here is most organizations are built for a centralized permission. This work AI specifically requires distributed responsibility. How do we shepherd the organization and work together in order to go through that kind of a change management?

[B]

If it's Simon's priority, then it's my priority on my end to enable this. One of the biggest thing this year is AI literacy fluency education. How do we educate our workforce to work off of a shared knowledge base so that they can have this agency that Simon is aspiring to. When we started after the AI boom, suddenly AI got democratized and everyone in a very user friendly fashion could interact with AI. And that was amazing. That raises a lot of awareness about possibilities, but also I think exposes us and any other healthcare organization to a lot of risks. So we had to hug AI close for some time and started educating, educating, educating so that people know if you're using this AI tool, it's great, it can make you more productive, but when you put something in it, it goes on the cloud. The data is now publicly available so you don't put phi into these publicly available tools, you should be using our enterprise instances of these AI assistants. So we started using every tool that we have available to us from emails that Simon and I send out to formal trainings and certifications, and we are still doing that. So I think that for me, I want to, I want all of our workforce to have that level of fluency in AI that we can really give agency to everyone to then build their own agents and don't cause or be less prone to causing an unintended harm. So that's AI education, top of mind.

[A]

For me, that makes a lot of sense and you know, it's so critical for the organization. I think for some it might be an easy leap and for others it takes a, a lot more to really help them understand what the AI is capable of doing and then understand the risks and being able to act appropriately because of it. And so I think that's really critical and cool to understand how you're developing those programs and then spreading it across the organization. And within that kind of mindset, what do you think the hardest thing about all of this that you'll have to do in the coming year will be?

[B]

The hardest thing? Simon, I'm going to steal your thunder here. The hardest thing has always been, and I think for the foreseeable future it will always be change management, adoption, changing the culture so that these tools make the intended impact that we're hoping they would make. Onboarding AI tools always requires a lot of changes to people's day to days and workflows. And we're talking about people who are already extremely busy and a lot of time set in their own ways. So I think that's something that in our executive leadership team and enterprise technology group, we're always thinking about change management and how do we change the mindset and make that cultural shift that AI can be successful because I think the technology is there for the most part for a lot of things that we want to accomplish. But does it really get adopted and used and make the impact? That's the big question.

[C]

And you've done a great job, Nassim, in really facilitating the organization because we really want to. Our focus is on ensuring quality, trust and usability that keep pace as these systems are growing. And technology is really helping reduce the cognitive administrative burden for our teams rather than adding to it. Right. And when you move from a tech enabled mindset to a tech forward organization that requires new ways of working, you know, new decision making norms and a lot of cultural adoptions and you know, and frankly, success depends on trust, you know, clarity and champion and the champions across the organization. You know, this is not something you mandate. You got to work together and in ownership, market, move it forward. And it's been a really interesting journey for Nassim and I as we shepherd this to the organization.

[A]

That's amazing to hear. And you know, truly it sounds like that move from the tech enabled mindset to tech forward organization is something that so many health systems and hospitals and healthcare organizations across the country are looking to do. And so your framework here, in some of the ways that you're looking at it from the leadership perspective, really is so helpful to understand. I'm curious, before we wrap up, I wanted to talk about growth too. Where do you see some of the best opportunities for organizational growth, especially as you're bringing in more of this education, more of these opportunities, and more of that tech forward mindset across the board?

[C]

You know, for me, it's really focusing on, you know, what I call blended intelligence when we talk about organizational growth, especially in healthcare, right. To bring the best knowledge to the point of decisioning and letting our human wisdom apply the context, values and the judgment at that point. This is where AI really has the capability to amplify human wisdom, not to replace it. And that's where we want to be and make sure that we're very responsible about it. Okay, and the one last thing is, I'll add, and I turned over to Nassim, is that this is also the opportunity where, as we discussed before, for innovation to be invisible. Right? So if we are doing the right things for our patients and our providers in a way that allowing them to practice the medicine at the top of their license and our patients to have the best experience and we'll take advantage of it.

[B]

Thanks, Simon. So Simon, hit on one of the most important aspects of growth, which is enabling people to be not only more productive, but also enjoy what they do day to day and take away the mundane repetitive parts of their workflows so that they can operate at the top of their lessons. So that's one aspect of growth. Another aspect of growth, at least for City of Hope, is patient access. We want more patients to have access to the world class care and research that we provide. And we are using a lot of technologies, including AI technologies to make that possible. So that in every community center, even outside of City of Hope, people can have access through our technology to the world class care and research that we provide. That's been something that has been top of mind always for me. Over the past nine years. And finally, technology is there to be able to enable it in a very reliable fashion. So that's also something that we are focusing on.

[A]

I love it. Thank you so much, Nassim and Simon, for joining us on the podcast today. And I'm looking forward to seeing you both as well at our annual meeting. I know you'll be doing a session, a fireside chat with one of our editorial leaders, just about everything we talked about here today, and digging deeper into some of these areas that are so important. When you think about technology and AI in healthcare, including clinical care as well, it's just incredible to see the opportunities and how you've been able to really maneuver around it at City of Hope. So I'm looking forward to learning more and seeing you in a couple weeks.

[B]

Thank you. Looking forward to it.

[C]

Same year. Thank you so much.