Risk Never Sleeps Podcast — Episode #173

"What We Don’t Know: Leading AI Governance with Humility and Clarity"

Guest: Anahi Santiago, Chief Information Security Officer at ChristianaCare
Host: Ed Gaudet
Date: December 22, 2025

Overview

In this episode, Ed Gaudet sits down with Anahi Santiago, CISO at ChristianaCare, to delve into the challenges and opportunities presented by AI adoption in healthcare. The discussion centers on AI governance, risk management, and the importance of humility and collective leadership in a rapidly evolving technological landscape. Santiago shares firsthand experiences from her organization's journey to implement and oversee AI while safeguarding patient safety.

Key Discussion Points & Insights

The Pace and Potential of AI in Healthcare

• Excitement and Impact:
  Anahi affirms that AI has transformative potential in care delivery and that ChristianaCare is eager to adopt and test the latest innovations.
  “There's a lot of exciting things that can happen in healthcare through the use of AI and that the impact that it can have on care delivery is monumental, transformative.” — Anahi Santiago [01:31]
• Adoption at ChristianaCare:
  ChristianaCare is technology-forward, with AI applications ranging from ambient listening and scheduling to traditional cybersecurity use cases.
  “We're a technology forward organization that wants to be the first to do everything.” — Anahi [01:54]

AI Governance and Guardrails

• Governance Structure:
  A robust AI governance process exists, grounded in a risk management rubric. Any new AI project goes through an assessment involving both governance and engineering teams.
  • Sandbox testing and rubric evaluation are central.
  • Use cases must be defined and mapped to existing capabilities.
    “We've stood up an AI governance process and have developed a rubric, a risk management rubric. And so any new projects...goes into that rubric...” — Anahi [02:41]
• Accelerating Assessment Cycles:
  Due to the surge of interest, governance meetings moved from monthly to weekly.
  • Over 10 new technologies introduced for assessment recently.
  • Emphasis on not being a bottleneck:
    “We can't be the ones to slow things down... We don't live in a culture where we move slowly.” — Anahi [05:59]

The Challenge of the Unknown

• Recognizing Limits:
  The greatest challenge is the velocity of change and the uncertainty around risks—ranging from cybersecurity to ethical, clinical, and bias-related.
  “We don't know what we don't know. Right. This is a really new technology...we're not experts.” — Anahi [03:21]
• Collective Responsibility:
  Risk ownership is shared—no one person or committee can fully "own" AI risk.
  • Cybersecurity history helps inform governance frameworks.
  • Education and cross-functional alignment remain a work in progress.
    “I’ve had to become very comfortable in acknowledging that I don’t know what I don’t know. And that has to be an acceptable answer. But collectively we can make the appropriate decisions.” — Anahi [04:08]

Practical AI Use and Personal Reflections

• AI Tools in Daily Work:
  Copilot and AI-based solutions help save time, especially for communication tasks (like email summarization). “Copilot has become a crutch for me...I no longer just do things from scratch. I asked Copilot to get something started and then I refined.” — Anahi [07:55]
• Work-Life Balance:
  Conference travel is challenging while maintaining ongoing job duties.
  “I still have a full time that I need to get done and people don’t want to wait because I’m traveling.” — Anahi [07:19]

Approaches to Leadership and Personal Growth

• Intentional Leadership:
  Anahi reflects on a key lesson—actively supporting team members' ambitions and not making assumptions about their satisfaction or growth. “Early on in my career...I would just put people in roles and just assume that they were happy...And so I changed my approach to being a leader to ensure that...they are not just fulfilling their existing role, but growing.” — Anahi [12:29]
• No-Regrets Mindset:
  Values growth from both good and bad decisions.
  • “I've always lived...a life of no regret because I feel like every decision...led to my growth.” — Anahi [12:29]

The Value of Networking and Learning

• Continuous Learning and Industry Collaboration:
  Santiago plans to leverage learnings from the conference and is especially energized by the Healthcare Sector Coordinating Council’s new AI initiatives.
  “The Healthcare Sector Coordinating Council just issued an announcement about the AI products that they're going to bring forth. That's actually. I'm very excited about that.” — Anahi [08:58]

Recognition and Tenure

• Decade CISO:
  Anahi has served over 10 years as CISO at ChristianaCare, previously holding privacy and security roles at Einstein Healthcare Network. “Ten and a half years.” — Anahi [09:44]
• Recent Accolades:
  Recognized as Global CISO of the Year by Cyber Defense Magazine, emphasizing the reward is making a positive impact in patient care.
  “Just knowing that every day we're impacting patients and healthcare positively is all that I need.” — Anahi [11:08]

Notable Quotes & Memorable Moments

• “We don't know what we don't know…I've had to become very comfortable in acknowledging that I don't know what I don't know.” — Anahi Santiago [03:21]
• “Every voice has to be equally loud and acknowledged in this work. It's not just a cyber security issue.” — Anahi [05:37]
• “Cyber safety is patient safety, as we say in the HSC.” — Ed Gaudet [11:24]
• “The one thing that we know is we can't be the ones to slow things down.” — Anahi [05:59]
• “Copilot has become a crutch for me, really. I no longer just do things from scratch...That’s really helpful.” — Anahi [07:55]
• “I've always lived...a life of no regret because I feel like every decision...led to my growth.” — Anahi [12:29]

Sports and Lighter Moments

• Philadelphia Sports Passion:
  Anahi’s favorite moment was the Eagles’ first Super Bowl win, recalling the ‘Philly Special’ play. “Just being in the building and watching our team win their very first Super Bowl ever in history was incredible.” — Anahi [19:48]
• Travel Anecdotes:
  Reflections on a recent trip to Australia, kangaroos, koalas, and sports banter around football stadiums and rivalries.

Where to Find Anahi Santiago

• LinkedIn:
  “I'm all over LinkedIn. Connect. Don't try to sell me things…I love sharing thought leadership there.” — Anahi [22:29]

Highlighted Timestamps

• Main AI governance discussion: [01:31]–[06:50]
• Risk and humility in leadership: [03:21]–[05:37]
• AI tools in daily leadership: [07:55]–[08:53]
• Leadership and regret: [12:29]–[13:28]
• Sports banter and lighter moments: [16:02]–[22:29]

Summary

This episode delivers deep, candid insights into the realities of AI adoption in health systems. Anahi Santiago exemplifies thoughtful, humble leadership—prioritizing collective governance, acknowledging the unknowns in AI risk, and promoting continuous professional and personal growth. Listeners gain both strategic and practical takeaways for advancing patient safety and responsible innovation in a complex digital health landscape.