1) Purpose & Framing
Assess enterprise AI readiness across people, process, data, technology, and governance in a healthcare context (HIPAA/PHI, safety, clinical quality), and produce a sequenced roadmap for safe, compliant AI adoption and measurable value.
Healthcare Lens
Clinical operations, revenue cycle, quality & safety, member/patient experience.
Risk & Compliance
HIPAA, HITECH, SOC2/ISO 27001, model risk management, PHI minimization.
Outcome
Ready-to-execute roadmap with 3–5 pilots and enterprise guardrails.
2) Objectives
- Baseline AI maturity in strategy, data, platforms, delivery, and governance.
- Identify high-value, low-risk AI use cases for healthcare operations.
- Define guardrails: privacy, security, safety, clinical validation & monitoring.
- Deliver a prioritized 12–24-month roadmap and pilot playbooks.
3) 12-Week Orbit Timeline
| Week | Focus | Key Activities | Outputs | Checkpoint |
|---|---|---|---|---|
| 1 | Kickoff | Scope, stakeholders, risk register; finalize data request v1. | Charter, cadence, RAID. | Exec sign-off |
| 2–3 | Discovery | Process walk-throughs (clinical ops, rev cycle, IT); data inventory. | Current-state maps, data lineage draft. | Weekly |
| 4–5 | Controls & Compliance | HIPAA/PHI flows; access; model/data policies; vendor review. | Controls gaps & risks. | Weekly |
| 6 | AI Readiness | Maturity scoring across dimensions; platform & tooling review. | Readiness heatmap v1. | Weekly |
| 7 | POV | Synthesis; value/risk matrix; stakeholder validation. | Diagnostic POV. | Phase review |
| 8–9 | Future State | Guardrails; reference architecture; operating model. | Target state v1. | Weekly |
| 10 | Pilots | 3–5 pilot charters; feasibility; metrics; clinical validation plan. | Pilot playbooks. | Weekly |
| 11–12 | Roadmap | Sequencing; investment; change plan; training & comms. | 12–24m roadmap; exec/board deck. | Close-out |
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4) Workshop Structures
W-1: Kickoff & Alignment (Week 1)
- Audience: CIO/CTO, CMIO/CNIO, CISO, CDAO, Ops
- Outputs: scope, success, risks, data protocol, cadence
W-2: Privacy, Security & Compliance (Week 4)
- HIPAA/PHI flows, de-identification, access, vendor posture
- Outputs: gaps list, guardrail requirements
W-3: Platforms & Tooling (Week 6)
- Foundation models, vector DB, integration, observability
- Outputs: platform options & standards
W-4: Use-Case Prioritization & Roadmap (Week 11)
- Score by value/risk/feasibility, sequencing, change plan
- Outputs: pilot slate + 12–24m roadmap
5) Interviews & Sample Questions
Stakeholders
- CIO/CTO, CISO, CDAO
- CMIO, CNIO, Clinical Quality & Safety
- Revenue Cycle, Patient Access, Contact Center
- Population Health, Pharmacy, Supply Chain
- Compliance/Privacy, Legal, Vendor Mgmt
Sample Questions
- Where does PHI flow today and how is access governed?
- Top manual processes ripe for AI? (rev cycle, prior auth, CDI, coding)
- Clinical validation needs for AI outputs? Who signs off?
- Model/Prompt logging & monitoring practices in place?
- De-identification strategy for training & eval? Synthetic data?
- Change-management capacity (training, comms, policy updates)?
6) Data Request — Healthcare Protocol
| Artifact | Examples | Owner | Format | Notes |
|---|---|---|---|---|
| System Inventory | EHR, PMS, RCM, LIS, RIS/PACS, CRM, Contact Center | IT/Apps | XLSX/DOC | Include integrations/APIs & IDP |
| Security & Privacy | BAAs, HIPAA policies, access matrices, DLP/SIEM reports | Security/Privacy | PDF/DOC | No secrets; architecture at high-level |
| Data Samples (de-identified) | Claims, encounters, notes metadata, scheduling, call logs | Data Office | CSV/Parquet | Remove direct identifiers; limited fields |
| Reporting & KPIs | Quality, safety, throughput, denials, LOS, auth TAT | Ops/Quality | PDF/XLSX | Current definitions & owners |
| Vendor Landscape | GenAI pilots, copilots, add-on modules, contracts | IT/Vendor Mgmt | DOC/PDF | Identify overlapping capabilities |
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- Least-privilege: start with de-identified samples; PHI only if necessary and approved.
- Secure transfer: client-approved encrypted channels; retention limits.
- Traceability: keep unique IDs for lineage and audit trails.
7) AI Readiness & Use-Case Slate
Readiness Dimensions (score 1–5)
- Strategy & Operating Model
- Data Quality, De-ID, Accessibility
- Platforms & Integrations
- Security, Privacy & Model Risk
- Delivery, MLOps/LLMOps, Monitoring
- Change, Training & Adoption
Candidate Pilots (examples)
- Prior-Auth Copilot (benefit checks, criteria summarization)
- Denial Prevention (CDI/coding prompts; claim scrubber)
- Clinical Note Summarization (handoffs, discharge instructions)
- Contact Center Assistant (intent, QA, after-call summaries)
- Population Health Risk Flags (explainable, nurse triage)
8) KPIs
Value
- PA turnaround −30%
- Claim denials −15%
- Agent handle time −15%
Quality & Safety
- Clinical accuracy ≥95% (pilot scope)
- Escalation/override rate tracked
Governance
- Access reviews quarterly
- Model/Prompt logs 100% retained
9) Deliverables
- Readiness Diagnostic & Heatmap (Week 6–7)
- Guardrails & Reference Architecture (Week 8–9)
- Pilot Playbooks (3–5) with metrics & validation (Week 10)
- 12–24-Month Roadmap + Executive/Board Deck (Week 11–12)
10) Governance & Cadence
- Weekly working session; bi-weekly exec update; Orbit reviews (W4, W8, W12)
- RAID log, scope control, pre-reads 48h prior
- Clinical validation gates for any clinical-adjacent pilot
11) RACI (Sample)
| Workstream | R | A | C | I |
|---|---|---|---|---|
| Readiness Assessment | Consulting Lead | CIO/CTO | CMIO,CISO,CDAO | Board/Compliance |
| Data & Privacy | Data Lead | CISO/Privacy | Apps/BI | Legal |
| Platforms & Tooling | Platform Arch | CTO | IT/Cloud | Vendors |
| Pilots | Pilot Owners | Exec Sponsor | Clinical/Ops | PMO |
| Roadmap | Engagement Lead | CIO | Finance/IT/Ops | All |
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