Tom Bonner

Tom Bonner


In the American Hospital Association’s 2023 report, Surveying the AI Health Care Landscape, the authors offer a thorough look at how Artificial Intelligence is transforming many segments of the national healthcare system. The report illustrates how the rapid development of AI technologies has massive implications in healthcare spaces. As the authors put it, “AI can create more intelligent processes and generate insights to deliver more effective, efficient, and affordable health care.”

This blog is not a summary of AHA’s Survey, but you should go read it—it is an easy-to-digest and insightful overview that can give even a total layperson a tacit understanding of how Artificial Intelligence is already impacting healthcare. Instead, this blog considers the challenge before healthcare leaders who are trying to determine not whether to incorporate AI technology into their systems—they must—but how to do so without compromising the capacity of their workforce to confidently deliver compassionate care. This requires highly intentional consideration by healthcare leaders.

After all, it is no secret that the rapid pace of AI development has sparked intense conversation and debate around the potential impacts on various segments of the healthcare workforce, from billing and coding to supply chain management to physician services. If you are searching for an example of just how seriously workers in other industries consider the threat—real or perceived—of AI vacuuming up jobs, look no further than the recently resolved SAAG-AFTRA and Writers Guild of America strikes. The strikes, which hinged in part on the use of AI for everything from AI writing content to AI-generated performers, ground the industry to a halt for months and cost hundreds of millions, possibly billions, of dollars. In healthcare, concerns in the workforce include job displacement, skills shifts, ethical implications, and data privacy risks, to name a few.

That said, the integration of Artificial Intelligence into our healthcare systems is happening now, and it will continue to play a more significant role in how health systems function and how care is delivered. One question for leaders looking to introduce these technologies should be how to do so without threatening the security of an already-tenuous workforce. To accomplish this, systems should have robust and transparent implementation and communications plans in place. These can include pilot programs, training resources, and storytelling to highlight effective human-AI collaborations.

Storytelling, in particular, can be a powerful means of shaping perceptions and rallying teams or an organization around a shared vision for the future. At CFAR, we often enter organizations where a coming transition—a new leader, a new plan, a new organizational structure—has created anxiety within the workforce. Employees are unsure whether they will be prepared for the future. Will I understand the new way of working? Will I be able to do my job effectively? Will there still be a place for me? These are some of the anxieties that health system leaders will need to navigate when implementing AI.

One tool we frequently use in these transitional settings is Histories of the Future, which invites participants to imagine alternative futures and what they would do to explore the interplay between their actions and the wider environment. This method leverages research[1], which suggests that people develop more vivid, interwoven stories when asked to think about a situation in the past tense than when asked to develop similar stories in the future tense. Hence, when people are asked to imaginatively leap out to a specific time and think about the system that they would like to see emerge, then to work backward in writing a developmental history of how they got there, they often think more concretely, weaving together planned and coincidental events, as well as linking political and technical events together into a narrative structure. In doing so, people can anticipate needs and challenges and formulate new solutions. By pulling employees’ concerns into a shared vision for how to address them, it may be possible to mitigate those anxieties.

In a healthcare setting, a History of the Future focusing on integrating AI solutions would allow employees to imagine how to enhance their organizational success and advance outcomes by positively leveraging AI to support their work. This technique of constructing histories of the future—as an element in a broader strategic or cultural change effort—may be a valuable method of unwinding anxieties about the risks AI poses, identifying opportunities to make its integration smoother and more valuable to the workforce, and working toward rendering better outcomes for both employees and patients.

For healthcare leaders considering how to effectively integrate AI into their systems, bringing their people along must be a cornerstone of a broad and thoughtful change effort. Histories of the Future, or similar visioning tools, can be helpful in that endeavor and must be a piece of a systemwide effort. By taking that broad perspective, AI solutions can amplify the efforts of a talented healthcare workforce to improve patient experience and outcomes and transform our national healthcare system for the better.

[1] Quist, Jaco & Vergragt, Philip. (2006). Past and future of backcasting: The shift to stakeholder participation and a proposal for a methodological framework. Futures. 38. 1027-1045. 10.1016/j.futures.2006.02.010.