The Unshakeables — “It’s not just innovation, it’s impact”: How AI is revolutionizing healthcare

Podcast by iHeartPodcasts • Date: November 11, 2025

Episode Overview

This episode of The Unshakeables explores how artificial intelligence is transforming the healthcare industry, driving new efficiencies, and reducing administrative burdens for clinicians and hospitals. Host Nick Richett (JP Morgan) speaks with Michael Gao, physician and President of Smarter Technologies, about the technology’s practical impact, market trends, and the road ahead for responsible AI adoption in healthcare.

Key Discussion Points & Insights

1. Backstory: Michael Gao & Smarter Technologies

[00:40]

• Michael Gao shares his transition from hospitalist at New York Presbyterian to AI entrepreneur.
• His experience with revenue cycle complexities inspired him to found Smarter dx, eventually expanding into Smarter Technologies, combining four entities:
  • Smarter dx (AI for accurate clinical records)
  • Pieces (AI-powered physician note generation)
  • Thoughtful (agentic AI platform)
  • Access (scaled delivery for revenue cycle ops)
• Mission: “To make sure that the patient story was accurately represented,” leveraging AI to improve both billing accuracy and operational efficiency.
  Notable quote:

“Between the DX and PISA side it's about getting that clinical story, that first invoice correct… then between the agentic and scale delivery side it's about jumping through the 257 hoops in a efficient and low cost way to get paid…” — Michael Gao [01:40]

2. Why is AI Taking Off Now in Healthcare?

[02:58]

• Historically, software in healthcare just digitized existing manual workflows rather than reduced cognitive load.
• Only recently has AI started “reducing the cognitive workload” for complex tasks like understanding patient journeys or streamlining billing, once exclusive to human expertise.
• Real-world AI now acts on complex, previously ‘human-only’ processes:
  • Interpreting labs, orders, and vitals to deduce what was treated.
  • Significantly reducing administrative staff needed for claim collections.
    Notable quote:

“For the first time in the past couple of years, what we're seeing on the AI side is the ability to reduce that cognitive workload and act… on things that historically have required human intelligence.” — Michael Gao [03:35]

3. Examples of Impact & Measurable Value

[05:38]

• Smarter Technologies’ AI achieves:
  • A 30–50 basis point margin lift for hospitals (on typical 2% margins).
  • 20–50% boost in administrative efficiency, especially with “agentic workflows backstopped by human experts.”
• Allows hospitals to redirect funds from admin to patient care.
  Memorable moment:

“You take…a business with 2% operating margins and really start to reshape what that business can look like…” — Michael Gao [07:10]

4. Market Trends: Consolidation & Integration

[07:48]

• Movement from niche/experimental AI startups to mainstream, practical solutions.
• Three key trends:
  1. Consolidation: Large incumbents acquiring AI startups, seeking integrated data platforms.
  2. Funding moderation: Fewer, larger rounds with a focus on proven business models.
  3. Cross-sector partnerships: Payers, pharma, and providers collaborating.
• Hospitals desire fewer, broader platforms, not countless niche vendors.
• Smarter Technologies’ growth is a response to market demand for unified solutions.
  Notable quote:

“Our strategy is to have combined the distribution of a scaled player and the ability to deliver of a skilled player.” — Michael Gao [09:26]

5. The Integration Phase of Healthcare AI

[11:00]

• Industry has entered an “integration phase”: Key for AI to be embedded within clinical and operational systems, not operate as siloed tools.
• Investors and buyers are rewarding companies who can seamlessly integrate AI into health workflows.
• Capital sources diversifying: PE firms, VC, health system venture arms.
• True AI adoption requires partnership and iteration with end users rather than top-down installation.
  Notable quote:

“You really can't separate the technology and product from the person using it anymore.” — Michael Gao [13:18]

6. Challenges to Responsible Scaling of AI

[14:27]

• Key challenges:
  • Ensuring AI decisions are controlled (remaining under provider oversight)
  • Ensuring transparency (ability to audit and understand AI decisions)
• “Black box” approaches are unacceptable with real patient lives at stake.
• Industry emphasis is on control, transparency, and responsible innovation. Quote:

“Scaling AI responsibly is going to involve making sure that the decisions made by AI are both controlled and transparent.” — Michael Gao [14:27]

7. Looking Forward: The Future of Healthcare AI

[15:43]

• Biggest potential: Shifting dollars from administrative costs to direct patient care and research & development.
• Major advances anticipated in R&D — e.g., drug discovery, design of novel treatments informed by big data.
• Ultimately AI will “amplify human experience,” handling repetitive tasks so clinicians can focus on care, not routine admin. Notable final thought:

“Not just innovation, it’s impact.” — Nick Richett [16:38]

Selected Quotes with Timestamps

• “For the first time… the ability to reduce that cognitive workload and act… on things that historically have required human intelligence.” — Michael Gao [03:35]
• “A 30 to 50… basis point lift to their margin, which, your average hospital has a 2% operating margin, so that can be quite a significant lift.” — Michael Gao [06:00]
• “Our strategy is to have combined the distribution of a scaled player and the ability to deliver of a skilled player.” — Michael Gao [09:26]
• “You really can't separate the technology and product from the person using it anymore.” — Michael Gao [13:18]
• “Scaling AI responsibly is going to involve making sure that the decisions made by AI are both controlled and transparent.” — Michael Gao [14:27]
• “Not just innovation, it’s impact.” — Nick Richett [16:38]

Timestamps for Key Segments

• [00:40] – Michael Gao’s backstory & Smarter Technologies formation
• [02:58] – Why AI is having real impact now in healthcare
• [05:38] – How AI drives margin and efficiency gains
• [07:48] – Market trends: consolidation, integration, partnerships
• [11:00] – The “integration phase” of AI in healthcare
• [14:27] – Challenges in responsible AI scaling: control & transparency
• [15:43] – The future: reallocation of dollars & amplified human experience

Tone and Takeaway

The conversation is candid and optimistic, focusing on real-world impact over buzzwords. Both speakers stress the importance of practical solutions, cross-sector collaboration, and transparency. The overarching message: Artificial intelligence isn’t just about new technology—when thoughtfully integrated, it creates meaningful impact by helping healthcare professionals focus on what truly matters: patient care and innovation.