Iremember a slumber party as a kid when my friend’s mother dressed as a fortuneteller, all scarves and bangles in a mystical basement setting, and individually told us details of our own lives with spine-tingling accuracy.
How could she know these things? Was it intuition? Or was she just good with a telephone? It turned out she had called our parents ahead of time and gathered fun, real-life details to sprinkle into our fortunes, with enough accuracy to spark our amazement and wonder.
Which brings me, in a roundabout way, to artificial intelligence — how it also predicts, weighs probabilities, has access to information we can’t always see, and sounds certain even when it’s unsure.
To show the evolution of computing, the Computer History Museum in Mountain View, California, guides visitors from the abacus — the ancient, hand-operated calculating tool — to Ameca, a robot with human-looking features created by Engineered Arts that uses OpenAI’s GPT-4 to chat with patrons and answer their questions. Ameca can shift between languages and mimic human expression. Ameca is a marvel, and when I asked it to identify the scariest robot, it suggested the Terminator. “Oh no, Ameca, I think it might be you,” I told the robot. Ameca tried to reassure me.
Ameca uses AI, “the ability of a computer system to perform tasks that normally require human intelligence — such as learning, reasoning, perception, decision-making and language understanding.” (A definition I just got from querying Copilot, Microsoft’s AI chatbot.) Ameca is just perhaps a more whiz-bang version of the technologies that are becoming increasingly common in homes and workplaces with access to technology.
Viewed one way, AI allows us to experience a little of the magic from that long-ago slumber party. The models generally have scraped data from a variety of sources — prompting a debate of its own about content creation, ownership and appropriate use — and can now mine and analyze
data in ways few of us could previously have predicted. It doesn’t just follow rules; the technology learns, adapts and sometimes acts.
For Catholic healthcare, and at CHA, these developments have led to a variety of ethical, spiritual, moral, medical and legal questions, debates and learnings. Several, but not all, are explored in this issue of Health Progress centered on AI. It’s not just a discussion — we’ve been doing that. This issue starts to shape responses to significant questions about the technology: how it should be considered, used and not used.
There’s more to explore in the future, including how to ensure more automated billing practices respect the dignity of patients, how to weed out human bias from large datasets used for population health findings, and how to protect mental health and promote healing in a world where technological innovation should support human tasks, but not overtake human connection.
It’s hard to believe that it was 1954 when mathematician Norbert Weiner wrote, “If we, in a small way, make human tasks easier by replacing them with a machine execution of the task, and in a large way eliminate the human element in these tasks, we may find we have essentially burned incense before the machine god. There is a very real danger in this country in bowing down before the brass calf, the idol, which is the gadget.”1
The promise of AI is staggering. So, too, are its implications for misuse, misplaced allegiance or idolatry. Much like early mistrust of the use of the abacus, or my own reservations about Ameca, it will be the human hand in testing, guiding and constraining AI that will chart its path. And one key question in the decision-making will surely be: Is this for the greater good?
NOTE
1. David A. Hollinger and Charles Capper, eds., The American Intellectual Tradition, Volume II, 1865 to the Present (Oxford University Press, 2016), 379.
You’ll notice that several authors reference Pope Francis’ Antiqua et Nova, and not Pope Leo XIV’s Magnifica Humanitas. Articles for this issue were written and edited prior to the release of Pope Leo’s encyclical on AI. We did include a link to the encyclical on page 41.
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Trevor Bonat, MA, MS, vice president, mission integration, Ascension, St. Louis
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Jennifer Stanley, MD, physician formation leader and regional medical director, Ascension St. Vincent, North Vernon, Indiana
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ARTIFICIAL INTELLIGENCE
‘An Opportunity to Be Transformative’
Health Systems Adopt AI Tools for Improved Patient Outcomes
ROBIN ROENKER Contributor to Health Progress
In his role as Trinity Health’s executive vice president and chief operating officer, Dr. Dan Roth frequently leads presentations on artificial intelligence integration in healthcare. They often use a similar descriptive phrase in their titles: Promise and Peril.
“It’s our job to maximize the promise and minimize the peril” in the adoption of AI tools, he explained.
It’s a goal shared by many Catholic health system leaders across the country who are working to balance the vast possibilities of an AI-driven healthcare transformation with a duty to responsibly adopt emerging AI tools.
“We know that this is an opportunity for us to be transformative in how we provide care,” said Roth. “But we don’t want to do technology for technology’s sake. We need to make sure we’re focused on the areas that are the highest ‘pain points’ for our patients and our caregivers.” The Livonia, Michigan-based system he works for provides services in 23 states.
A LISTENING TOOL
Catholic health systems across the country now commonly use ambient listening products with embedded AI to automatically generate patient visit notes, particularly in their primary care and other outpatient settings. Products such as Microsoft’s DAX Copilot, which can integrate with popular electronic health record (EHR) platforms, like Epic, are reshaping the patient-provider connection in positive ways.
With an ambient listening scribe activated, physicians no longer have to talk to patients while typing notes at a computer. They can get back
to having true face-to-face dialogue, focused on building a “healing connection of understanding about what might be going on,” said Byron Yount, PhD, chief data and AI officer and vice president of transformation operations at Mercy, which serves patients in Arkansas, Illinois, Kansas, Missouri and Oklahoma.
At Trinity Health, roughly 1,500 outpatient providers are currently using ambient scribing. “We are using it at scale, and we’re looking to expand it to an inpatient setting for our hospitalists and nurses and even into the emergency room,” Roth said. “Its scope will continue to grow.”
Patients are noticing the difference — and say they appreciate not having to talk to their provider across a laptop screen. With ambient listening in place, patients reported “they felt for the first time [in recent memory] that their providers were fully engaged in listening,” said Dr. Ann Cappellari, chief medical information officer at SSM Health, headquartered in St. Louis. “It’s a tool that can help restore that sacred provider-patient construct. And fostering that relationship is huge for healing.”
Systems also report success using AI-supported tools to efficiently create patient treatment notes and discharge summaries across their inpatient settings. Not just a time-saver for clinicians, the resulting documents also serve as a helpful resource for patients who can refer to
them as needed in their online patient portal to stay informed about each step of their care.
“It helps everyone all around,” Cappellari said. “The AI-supported summaries include citations that have rigor and provenance. Patients can refer to their summaries and see the labs that they got, any prescription changes and their next care directions.”
Health executives predict that, in time, AIdriven ambient listening tools and care note summarization tools will become even more integrated and robust. In the future, they will be able to lay out and summarize follow-up reminders for clinicians and provide even more helpful contextual data for patients.
Clinicians say AI, when well-integrated into healthcare, will do more than increase ease of record-keeping and speed up diagnostics. They’re seeing ways it can aid in identifying illness and streamlining treatment when time is of the essence.
As a result, many systems are exploring how AI-supported services might offer a pathway toward earlier cancer detection. Health executives report early forays into using AI systems to review mammography images, as well as lung and colorectal cancer screenings, among others.1
Given AI’s dexterity at pattern recognition, it can excel at spotting and flagging even small abnormalities on an X-ray, MRI or CT scan and identifying which images should receive immediate review.
When a patient gets a lab result back in their patient portal, these reports may soon offer additional interpretive context about what their cholesterol or other test findings may mean, Roth explained. “This is an AI-supported function that’s coming in the not-so-distant future — and it’s one that can help patients better navigate their own care journeys.”
NEW FRONTIERS OF ADOPTION
Systems like Trinity Health, Mercy and SSM Health have also successfully deployed AI-supported tools to augment their radiology and imaging services.
“Radiologists are still reading every study, but they’re doing it in a way that’s faster and better because of the technology,” Roth said. “The AI is empowering and enhancing the work of our professionals.”
Given AI’s dexterity at pattern recognition, it can excel at spotting and flagging even small abnormalities on an X-ray, MRI or CT scan and identifying which images should receive immediate review. “It enhances the discovery of nuanced things. It can prevent tired [human] eyes from potentially missing something,” added Mercy’s Yount.
“Lung cancer screening involves rapid, low-dose CT scans that identify small pulmonary nodules, many of which will need followup,” explained Dr. Thomas McGinn, senior executive vice president and chief physician executive officer at CommonSpirit Health, headquartered in Chicago. “AI tools can immediately recognize which nodules are at a lower and higher risk [for cancer development], and whether they’re changing from six months to a year between scans.”
Trinity Health, CommonSpirit, SSM Health and others have also found success utilizing AI to speed stroke detection.2 AI-backed platforms, including RapidAI, Brainomix and Viz.ai, 3 can help clinicians more swiftly assess patients who present with stroke symptoms — and offer data insights to inform best pathways of care — potentially lowering patients’ risk of long-term strokerelated impairment or death.
“We’ve seen tremendous benefits from our acute stroke [AI adoption] programs,” McGinn said. With appropriate AI-backed tools in place at community hospitals, “imaging is immediately transferred to the stroke center, so that stroke teams can be activated and a treatment plan developed more quickly than ever before.”
Cappellari agreed that AI’s capacity for stroke detection has been transformative. “It can detect a stroke within seconds of the CT getting done,” she said. “It then pushes a ping to the radiologist and to an interventionalist,” allowing the care team to quickly facilitate appropriate treatment.
At Mercy, an AI tool called Sepsis ImmunoScore 4 will support providers in identifying and flagging hospitalized patients who may be at higher risk of developing sepsis. Several systems
also use AI-supported tools to help clinicians evaluate when patients may be ready for hospital discharge or to identify patients with a higherthan-average likelihood of hospital readmission due to chronic illness.5
Meanwhile, Roth points to AI-EKG tools as another area ripe for expansion. “We are discovering that [with support from AI] we can get information from EKGs that we never thought was possible,” he said. New research shows that AI tools can analyze EKG results to detect patients at high risk for heart failure and other heart diseases.6
MOVING FORWARD FOR PERSONALIZED MEDICINE
Many of the AI uses in healthcare today focus on “being more proactive and personalized and predictive with care,” said Yount. He believes AI will increasingly improve its ability to both support earlier disease detection and identify optimized prevention plans and treatment options for patients, based on their genetics, disease risk factors and other key health metrics.
“We are seeing that AI can help us understand what types of treatments might be more effective and applicable for a given individual, and that type of application of AI is only going to get better over time,” Yount said.
Yount was involved in helping create an inhouse predictive AI tool in use at Mercy that evaluates electronic medical records to identify and flag patients at increased risk for various diseases, such as colorectal cancer. Once the system identifies these patients, their providers can then engage them in discussions about the importance of cancer screening and the right level of screening given their risk.
“The [AI] algorithms help you target your diagnostic tools more efficiently and effectively,” Yount said.
AI’s ability to manage large troves of data makes it an especially helpful tool as hospitals navigate increasingly complex cancer screening guidelines, CommonSpirit’s McGinn said. He shared, as an example, the ways that recommended screening guidelines for various cancers can differ by age, depending on a patient’s health history and prevalence of cancer in their family. Multiply that across all cancer types and among thousands of patients, and it can feel difficult for human providers to keep up.
To address this challenge, CommonSpirit uses robotic process automation, a software solution complementary to AI, to automatically calcu -
ARTIFICIAL INTELLIGENCE
late patients’ personalized risk for key diseases based on their EHR data. Right now, the system is focusing on breast, colon and lung cancers, and the process is programmed to “automatically offer a screening test to be approved by the physician” for patients deemed at high risk, McGinn said. “We’ve seen huge increases with our cancer screening as a result, in some areas as much as a 50% increase year to date.”
At Providence, teams created their own inhouse AI tool, called Provaria, to facilitate more seamless patient messaging management.7 The system categorizes and directs patient messages in MyChart to appropriate response teams, allowing doctors to quickly identify and respond to patients who need immediate care first, while directing less urgent queries — like scheduling issues — to front office support staff.
The tool “reads” incoming patient messages using AI, then assigns them a triage category accordingly, explained Dr. Ford Parsons, associate vice president of clinical informatics and chief medical information officer of AI and engineering at Providence, headquartered in Renton, Washington.
The result: Patients whose symptoms warrant an appointment often see a provider the same day they send their message.
“With symptom messaging, our turnaround time [using Provaria] decreased by almost half,” Parsons said. “So, from a patient perspective, they’re getting information back much more quickly.”
DATA-DRIVEN CARE ADVANCES
Multiple Catholic healthcare systems — including Providence, Trinity Health, CommonSpirit Health and Bon Secours Mercy Health — have partnered with Truveta, an AI-powered data intelligence company launched in 2021, to develop a comprehensive database of more than 130 million patients’ de-identified EHR data.8
The Truveta platform gives its 30 partnering healthcare systems access to research-ready, anonymized patient data, which can be leveraged to assess and improve patient care quality, analyze the effectiveness of emerging therapies or track longitudinal patient outcomes, among other applications.
Truveta was “founded with the notion that we can use AI and computational systems to solve [healthcare] challenges through deep, rigorous research using de-identified patient data,” said
Dr. Michael Simonov, the company’s senior vice president of product.
Truveta’s newly launched Truveta Genome Project aims to create the “largest and most diverse de-identified database of genotypic and phenotypic information ever assembled,” according to the company.
The project’s large-scale scope will allow it to create a dataset that’s far more representative and inclusive of diverse ethnic and sociogeographic groups than any before assembled — leading to more equitable treatments and care predictions, the company’s leadership believes.
“It’s an unparalleled investment to sequence millions of genomes for patients,” Simonov said. “It’s a future-looking perspective to the world of precision medicine, where we will treat every patient as distinct.”
With future insights from the Truveta Genome Project, clinicians may eventually guide each patient’s unique clinical care — and even predict or prevent certain disease progression — on the basis of their genetic makeup.
At Mercy, the system has pursued global partnerships in data and AI innovation, Yount said, including its founding partnership with Mayo Clinic Platform. This collaboration combines clinical experience, technical capabilities and decades of de-identified patient data from its partner organizations.
ney problems or eye problems,’” Roth said. “We believe that [with AI] we will be able to learn and be better predictors of which patients need more focused support and interventions.”
ETHICS AND MONITORING
Even with all of AI’s promising potential — or, rather, perhaps because of it — health system leaders are treading cautiously and deliberately as they work to advance AI usage across their footprints.
At CommonSpirit, the health system has assembled a robust group of ethicists, administrators, clinicians and AI specialists that meets at least weekly to review performance metrics from its current AI usage and to evaluate the merits of new potential applications.
“It’s a way of saying, ‘We’re embracing this, but we’re embracing it in a thoughtful way,’” McGinn said.
During these ethics, data, algorithm and governance reviews, potential new AI tools undergo a thorough assessment of their diagnostic, therapeutic and preventive capabilities. That’s particularly true for any applications that are close to bedside or that engage with patients in any way, McGinn said.
“If we use AI thoughtfully with clinician involvement, we can actually enhance the human connection of medicine.”
— DR. FORD PARSONS
By drawing on large and diverse populations, this work focuses on identifying risks earlier, forging more representative studies, and developing new diagnostics and medical interventions in ways that no one system can achieve alone.
Mercy clinicians are already using AI-driven insights from this partnership to better understand “how different phenotypes can be treated more effectively with different types of medicine and medicinal interventions,” Yount said.
As AI capabilities progress, “it will be able to predict for physicians, ‘These are the patients whose diabetes will likely progress,’ or ‘These are the patients who will be more likely to have kid-
Providence, similarly, engages AI review council workgroups composed of doctors, data scientists, informaticists, nurses and ethicists who, together, evaluate workflow and adoption of AI to “make sure that we’re getting the benefits of AI without any of the harm or safety risks,” Parsons said. When AI adoption is done with intention and within frameworks of ethical use, it has the power to provide patients with “a straighter line to care,” said Yount. He added that at Mercy, a key goal is to ensure AI is adopted equitably, so that both the most resourced and the least resourced can benefit from its potential.
Cappellari also noted excitement about AI’s potential to transform healthcare for the better. “It actually feels like [AI] is a care changer,” she said. “It seems to have mass potential for benefit, patientwise, clinicianwise and health systemwise.”
Even as AI advances, Cappellari notes that it will never take the human out of the loop. Indeed, most executives agree that when done well, AI has the power to let humans excel at what they do
ARTIFICIAL INTELLIGENCE
Putting Ethics Into Practice: AI Use in Catholic Health
DANIEL J. DALY, PhD Executive Director, Center for Theology and Ethics in Catholic Health
Artificial intelligence is rapidly transforming healthcare. From predictive analytics and clinical decision support to administrative automation and virtual assistants, AI promises to reshape how care is delivered, experienced and organized. This transformation presents both opportunities and challenges for Catholic healthcare to practice the healing ministry.
This past spring, the Center for Theology and Ethics in Catholic Health hosted a two-day conference at Boston College, “Artificial Intelligence, Authentic Mercy: Navigating AI Ethics in Catholic Health,” gathering leaders from theology and ethics, healthcare, the Church and the AI industry. Insights from the conference revealed significant implications for organizational AI ethics in Catholic healthcare.
The role of AI adoption and use in Catholic healthcare must be approached as an organizational ethics issue. Organizational ethics “deals with value-related issues concerning an organization in the broadest sense: mission, vision, sponsorship, governance and leadership.”1 Organizational ethics is principally concerned with the ethical quality of an organization’s structure and culture, which are often reflected in organizational charts, position descriptions, policies and formation programs.2
To guide its practice effectively, ethical norms for the use of AI in Catholic health must be embedded in organizational structures, culture and interdisciplinary discernment.
TECHNO-OPTIMISM AND HEALTHCARE
Influential and powerful industry and thought leaders hold a stridently optimistic, and even utopian, outlook regarding the future of AI in healthcare. Elon Musk claims that by 2030, “there will probably be more Optimus robots [Tesla’s AIpowered robot] that are great surgeons than there are all surgeons on earth.”3 Bill Gates predicts that by 2035, human physicians will not be needed due to AI. Gates argues that the globe needs AI physicians to solve the ongoing shortage of healthcare professionals.4 Futurist Ray Kurzweil predicts that human beings may soon reach longevity “escape velocity,” a point at which medical advances outpace aging itself. In such a world, death would become optional rather than inevitable. AI-directed nanobots operating within the human body would prevent decline.5
These predictions and their techno-optimism belie a particular vision of medicine’s ends and nature. In this vision, technology is the solution to all societal problems. The current issues in healthcare are technical problems requiring technical solutions. Further, this vision understands
the body as a machine and medical professionals as its technicians. The patient-as-person recedes from view, leaving only manipulable flesh and bone. This vision must be interrogated in light of the core commitments of Catholic healthcare.
THE CATHOLIC VISION OF HEALTHCARE
The late Catholic physician-ethicist Edmund Pellegrino argued that the end (or goal) of healthcare is the patient’s good. The good produced in healthcare, as in education, resides in the person who is served and enabled to flourish, not in any external product, such as profit. Pellegrino distinguished between models of medicine that reduce the physician to a “body mechanic” and those that understand the physician as a healer and helper. Because healing emerges from a relationship between the healer and the patient, “The central feature of healthcare is the personal relationship between a health professional and a person seeking help.”6
Further, healing is not mere curing but restoration to wholeness. Although healing is principally directed toward a patient’s physical and psychological wholeness, it opens possibilities for social and spiritual well-being. This vision of healing as wholeness enabled by the provider-patient relationship is affirmed by Catholic healthcare because it reflects Jesus’ healing ministry.
Consider Jesus’ healing of the man with leprosy in Mark’s Gospel (Mark 1:40-45). Upon seeing Jesus, the man kneels and begs to be made “clean.” Jesus touches and cures him of his affliction. Persons with leprosy were rarely, if ever, touched in the ancient world, so Jesus’ touch both mediates a relationship between the healer and the healed and reintegrates the man into the community. Jesus then tells the man to show himself to the priests but to say nothing to others. Overcome with joy, the man becomes one of the first evangelizers in the Gospels, publicizing his healing at Jesus’ hands, so that “people kept coming to him from everywhere.”
The man is not only cured of his leprosy, but he is also restored to the community, and his faith is cultivated. The healing encounter touches his whole person, not merely his body. Jesus’ healings open opportunities for the marginalized to flourish. Note that throughout his ministry, Jesus heals those who are at the margins of society: those who are blind, deaf, mute, paralyzed and suffering with leprosy and hemorrhage. These are the ancient world’s untouchables, whose health conditions
serve as markers of social exclusion.
Jesus invites his followers into his healing ministry. In Luke’s Gospel, Jesus tells his disciples that when they enter a town, they should “cure the sick in it and say to them, ‘The Kingdom of God is at hand for you’” (Luke 10:9). Jesus invites his followers to proclaim the Kingdom by healing the sick. Catholic healthcare, then, is not only a humanitarian enterprise. It is a sign that God loves all persons, and in a special way, those who are poor, sick, disabled, depressed, blind and deaf. It is not merely a provider of services but a ministry that is a public, organized expression of the Church’s commitment to care for the sick and suffering.
The invitation to heal involves healing in a particular way — mercifully. Note that after the man with leprosy begs Jesus for healing, Jesus was “Moved with pity, he stretched out his hand, touched him, and said to him, ‘I do will it. Be made clean’” (Mark 1:41). In the original Greek, splagchnizomai (translated as pity or compassion) connotes a deeply visceral, emotional response to human suffering. Thus, Jesus’ response to this man involves both compassion and a work of mercy. He has an internal reaction to his suffering and an external response to heal the man. This dual response is the essence of the virtue of mercy, which involves suffering with the other and healing him of his affliction.
This brief study shows that Jesus’ healing ministry — and by extension, Catholic healthcare — has a unique goal, a clear rationale, a commitment to particular persons, and a specific manner of pursuing that goal. First, the goal of healing is the person’s physical, emotional and spiritual wellbeing. Second, this work is undertaken to give witness to God’s universal love and the coming of God’s Kingdom. Third, the healing ministry is oriented toward particular persons: the sick, with a preferential concern for those who are marginalized, vulnerable or excluded. Finally, it prescribes that care should be a work of mercy, in which caregivers do not remain distant from those who suffer, but enter into the suffering of the other, accompanying patients in their time of distress.
These four marks must continue to guide Catholic healthcare and must inform the adoption and use of AI in the ministry.
EMERGING AI NORMS IN CATHOLIC HEALTHCARE
The following norms emerge from this understanding of Catholic healthcare’s healing ministry and its core values and virtues. In addition, these
are the specifications of AI norms contained in various Vatican-issued documents, including Antiqua et Nova (“Ancient and New”). These norms reflect an emerging consensus about the ethical development, adoption and use of AI in Catholic healthcare:7
AI must promote patient well-being and whole-person flourishing.
AI must enhance, not erode, the quality of the patient-provider relationship.
AI should expand access to care, especially for those who lack it.
AI must be actively monitored to reduce bias and prevent the widening of healthcare inequalities.
Human decision-makers must remain responsible and accountable for all healthcare actions. Healthcare professionals should not delegate moral responsibility to algorithms.
AI use should promote the well-being of healthcare professionals, administrators and staff, respecting the dignity of their work.
The environmental impact of AI should be acknowledged and mitigated.
These norms provide important but necessarily general guidance. Because AI technologies are evolving rapidly, ethical discernment must be ongoing and context-dependent. Decisions about AI adoption should involve interdisciplinary discernment. Clinicians, ethicists, administrators, technologists and patient advocates each bring perspectives essential to good discernment. None of these groups can discern well in isolation from the others. In addition, leaders must not reduce ethical reflection on AI to legal compliance. Instead, it should engage the deeper theological and ethical goods at stake in Catholic healthcare.
INSTITUTING ETHICAL NORMS
ARTIFICIAL INTELLIGENCE
cer, VP of mission, the board of directors, physicians, nurses, custodians and other support staff. Performance expectations define each position. Physicians are charged with providing medically indicated, beneficial treatment to patients, while CFOs are charged with monitoring and enhancing the organization’s financial health. Catholic health ministries should be structured to enable and reward physicians who provide excellent patient care and to constrain and penalize those who practice below the standards of care. Thus, we find that a hospital is more than a mere collection of individuals. Instead, it is a highly structured organization that presents position-holders with enablements and rewards, as well as constraints and penalties, on their actions. Therefore, it matters a great deal what the organization enables, rewards, constrains and penalizes, as employees tend to pursue rewards and avoid penalties.
An essential tool for operationalizing the previously mentioned norms (or any norms the organization values) is to have them represented in the annual performance goals and compensation review of the position-holder. For example, if a hospital CEO knows that their performance will be evaluated by the board based on the patient’s
Personifying AI blurs the distinction between person and machine and creates the false impression that the AI’s output reflects a reasoned judgment or emotional response deserving the same respect as a human being’s.
Catholic healthcare leaders should integrate the norms into the structures and cultures of each Catholic healthcare organization.
A structure is a web of relations among social positions. 8 For example, a Catholic healthcare organization is structured through the relations among its sponsors, CEO, chief financial offi -
AI-related experience in the clinical setting, the CEO is highly motivated (and likely) to direct the chief information officer, chief medical officer and others to monitor patient satisfaction reports with AI in their care. Likewise, if the CEO’s annual review includes a goal of increasing clinicians’ job satisfaction, the CEO will direct others to evaluate each AI tool, considering its expected effects on clinicians before adoption. Ethical norms that are not embedded in position descriptions and performance goals are largely impotent.
Culture also plays an important role in shaping how ethical values and norms affect the wellbeing of patients and healthcare professionals. A healthcare organization’s culture contains the
ideas and values that it endorses and enforces.9 For instance, in accordance with human dignity, every Catholic system affirms racial equality. Because these systems endorse this belief, they also enforce it. Therefore, healthcare organizations penalize (often firing) employees who utter racist comments.
Language plays a significant role in shaping culture and actions. Personifying language gives the impression that AI is a person with agency, decision-making capacity, moral responsibility and emotional responses. As Antiqua et Nova affirms, AI applications are not persons.10 Such tools do not think, reflect, decide, feel or care. They cannot love or experience empathy. For these reasons, Catholic healthcare organizations should create a culture that discourages the personification of AI. Personifying AI blurs the distinction between person and machine and creates the false impression that the AI’s output reflects a reasoned judgment or emotional response deserving the same respect as a human being’s.
Formation programs are key to fostering a healthy AI culture. Such programs should, for example, discourage position-holders in Catholic health ministries from using personal pronouns (for example, he or she) when discussing an AI or its outputs, and referring to AI as possessing or enacting moral traits, such as empathy. Patients should always know they are interacting with an AI and not a human person. If a developer gives a human name to an AI, it is prudent to add “AI” to the end to prevent clinicians or patients from viewing it as a person.
PROMOTING HUMAN FLOURISHING IN THE AI AGE
The task before leaders in Catholic health is to create organizational structures and culture that enable clinicians and administrators to adopt, use and evaluate AI based on the healing and flourishing of patients, the well-being of healthcare professionals, and the witnessing to God’s love for all persons, especially those who are sick and poor.
In the end, the test for each AI tool is whether it enables Catholic healthcare ministries to “cure the sick … and say to them, ‘The Kingdom of God is at hand for you.’”
DANIEL J. DALY is the founding executive director of the Center for Theology and Ethics in Catholic
Health. He is also an associate professor of moral theology at Boston College’s Clough School of Theology and Ministry.
NOTES
1. Fr. Gerard Magill and Lawrence Prybill, “Guidelines for Organizational Ethics,” Health Progress 82, no. 4 (2001): 12-14.
2. Daniel J. Daly, “The Virtuous Hospital: A Catholic Organizational Healthcare Ethics,” The Journal of Healthcare Ethics and Administration 8, no. 2 (2022): https://doi. org/10.22461/jhea.1.71635.
3. Orianna Rosa Royle, “Elon Musk Shares 4 Bold Predictions for the Future of Work: Robot Surgeons in 3 Years, Immortality, and No Need for Retirement Savings,” Fortune, January 13, 2026, https://fortune. com/2026/01/13/elon-musk-future-of-workpredictions-retirement-lifespan-robot-surgeons/.
4. Lee Chong Ming, “Bill Gates Says AI Can Help Solve Worker Shortages in 2 Surprising Professions,” Business Insider, April 16, 2025, https://www.businessinsider. com/bill-gates-ai-job-shortages-doctors-teacherswork-free-time-2025-4.
5. Ray Kurzweil, The Singularity Is Nearer: When We Merge with AI (Penguin, 2024).
6. Edmund Pellegrino, “The Commodification of Medical and Health Care: The Moral Consequences of a Paradigm Shift from a Professional to a Market Ethic,” in Pellegrino’s Clinical Bioethics: A Compendium, eds. G. Kevin Donovan, David G. Miller, and Claudia Ruiz Sotomayor (Catholic University of America Press, 2025).
7. Daniel J. Daly, “Statement from the ‘Artificial Intelligence, Authentic Mercy: Navigating AI Ethics in Catholic Health,’ Conference–March 21, 2026,” Center for Theology and Ethics in Catholic Health, https://site.chausa. org/docs/default-source/ctech/ctech-conferencestatement-with-signatures-3-25-final.pdf.
8. Douglas Porpora, “Who is Responsible? Critical Realism, Market Harms, and Collective Responsibility,” in Distant Markets, Distant Harms: Economic Complicity and Christian Ethics, ed. Daniel K. Finn (Oxford University Press, 2014), 3-24.
9. Dave Elder-Vass, The Reality of Social Construction (Cambridge University Press, 2012), 44.
10. Dicastery for the Doctrine of the Faith and Dicastery for Culture and Education, “Antiqua et Nova: Note on the Relationship Between Artificial Intelligence and Human Intelligence,” The Holy See, section 59, January 28, 2025, https://www.vatican.va/ roman_curia/congregations/cfaith/documents/ rc_ddf_doc_20250128_antiqua-et-nova_en.html.
Ethics on Call is the official podcast of the Center for Theology and Ethics in Catholic Health. Join the center’s leaders, Dan Daly and Tom Bushlack, for monthly reviews of recent scholarship, including a recent episode: “Expert Panel Discussion on AI, Ethics and the Future of Catholic Healthcare.”
Visit theologyandethics.org/podcast
ARTIFICIAL INTELLIGENCE
Listening Differently: What Ambient AI Is Teaching Us About Care
WILL LANDRY
Senior Vice President and Chief Information Officer, FMOL Health
In exam rooms across the country, something subtle but significant is changing. At FMOL Health, that change is already taking shape. Clinicians are beginning to practice in a different way, less focused on screens, more focused on patients, while documentation happens in the background.
Ambient listening, a tool that uses artificial intelligence to securely listen to clinical conversations and generate structured medical notes, is helping make that shift possible.
But the experience of implementing this technology has underscored something broader: Adopting AI in healthcare is not primarily a technical challenge. It is an organizational one that requires clarity of purpose, trust and sustained attention to how care is delivered.
STARTING WITH A REAL PROBLEM
Like many health systems, FMOL Health began exploring ambient AI in 2024 in response to a familiar challenge: the growing burden of clinical documentation and the possibility that emerging technology could meaningfully address it. The Baton Rouge-based health system provides care in Louisiana and Mississippi.
Our early efforts focused on ambulatory settings, including internal medicine and family medicine, where documentation demands are especially high. Over time, use has expanded into specialty areas and emergency departments, with additional pilots beginning in nursing.
Today, nearly 400 clinicians across our system
are actively using one of two approved ambient listening tools. These tools are primarily used to generate encounter notes, with providers reviewing and approving all documentation before it becomes part of the medical record.
For providers who use this technology consistently, and in most encounters, the impact has been measurable. Research by an independent third party that included data from FMOL and two other health systems revealed that clinicians spent less time on charting, particularly outside of scheduled clinic hours.1
RECENTERING THE PATIENT VISIT
While reducing documentation burden was the initial goal of using ambient listening, one of the most meaningful outcomes has been a shift in the clinical encounter itself, with the average time to close an encounter note significantly reduced.
As documentation becomes less intrusive, providers can be more present. Patients notice the difference.
Across FMOL Health, patient satisfaction has improved as clinicians spend less time divided between the patient and the computer, and more time engaged in the moment.2 The technology, in
WHAT AMBIENT AI IS TEACHING US ABOUT CHANGE
Technology works best when it’s nearly invisible.
Tools that support care without disrupting it are more likely to be adopted and sustained.
Efficiency isn’t just about time saved.
It’s about how that time is reinvested in more meaningful work.
Trust is built, not assumed.
Transparency, validation and human oversight remain essential.
Adoption is a human process.
Engagement, education and workflow integration matter as much as the technology itself.
Unexpected outcomes can be the most valuable.
Be open to improvements, especially the importance of those in patient connection and clinician satisfaction.
effect, is helping restore something foundational in healthcare: human connection.
In this way, ambient AI is doing more than improving efficiency. It is reshaping the experience of care, placing the relationship at its center once again.
RETHINKING EFFICIENCY
One of the assumptions often tied to new technology is that it will reduce the time spent working. In practice, the impact has been more nuanced.
At FMOL Health, some clinicians are spending less time on after-hours documentation. Others are using that time differently, shifting from catching up on previous notes to preparing for upcoming visits.
This kind of previsit planning can be more purposeful and professionally rewarding. It reflects an important insight: Addressing burnout is not only about reducing time spent working, but about improving how that time is used.
ongoing evaluation. Starting in targeted settings allowed teams to refine workflows, identify challenges and build confidence before expanding adoption.
There was some initial hesitancy among providers, which was an expected response to any meaningful change in clinical practice. Over time, as clinicians experienced the benefits firsthand, engagement has grown and adoption has followed.
Education has been central to that process. Digital health and electronic medical record teams support clinicians with training on how to incorporate changes into workflows, verify accuracy and communicate with patients about the role of AI in their care.
In this way, ambient AI is doing more than improving efficiency. It is reshaping the experience of care, placing the relationship at its center once again.
Ambient AI, in this context, is not simply making work faster; it is helping make work more meaningful by allowing greater focus on the patient and less time on clerical documentation.
FROM PILOT TO PRACTICE
While ambient AI technology may be advanced, successful implementation depends on very human factors.
At FMOL Health, the approach has emphasized careful piloting, clinician engagement and
This “human-in-the-loop” model reinforces that AI is an assistive tool, not a replacement, for clinical judgment. It further reduces the risk of language inaccuracies or transcription errors through human-led review and approval.
BUILDING THE CONDITIONS FOR TRUST
As with any use of AI in healthcare, questions of privacy, accuracy and governance are critical.
Patients may not always be aware that ambient tools are being used unless clinicians explain
them. Clear, simple communication — what the technology does, how information is used and how it is protected — helps build confidence.
Internally, FMOL Health has implemented review processes and guidelines to support appropriate use. These structures are not barriers to innovation; they allow it to scale responsibly. Governance includes a technical AI committee within Information Services (IS), reporting through IS Steering, and an AI ethics group reporting to the health system’s Ethics Committee.
This approach also reflects a broader commitment grounded in Catholic healthcare: New technologies should be introduced thoughtfully, in alignment with our mission team, and with careful consideration of their impact on both patients and those who provide care.
LOOKING AHEAD
Ambient listening technology is one of the more immediate and practical applications of AI in clinical care. But the lessons emerging from its implementation extend beyond documentation.
At FMOL Health, early results, including strong clinician adoption, improved patient experience and a positive return on investment, suggest that success is not driven by the technology alone, but by how it is introduced and supported.
QUESTIONS FOR DISCUSSION
ARTIFICIAL INTELLIGENCE
As healthcare continues to evolve, the question is not simply which technologies to adopt, but how to integrate them to strengthen the human experience of care.
In that sense, implementing ambient AI is not just about improving documentation. It is part of a broader effort to ensure that, even as technology advances, the focus of care remains exactly where it belongs: on the patient.
WILL LANDRY focuses on healthcare information systems, technology and innovation at FMOL Health. He leads the health system’s shift toward cloud-based platforms, automation and virtualization.
NOTES
1. “Suki ROI Validations 2026,” KLAS, January 22, 2026, https://klasresearch.com/report/suki-roi-validations2026-cross-organizational-results-from-suki-s-clinicalintelligence-platform/3869; “Transforming Clinical Workflows: How Franciscan Missionaries of Our Lady Health System is Partnering With Suki to Reduce Burnout,” Suki, August 12, 2025, https://www.suki.ai/ blog/transforming-clinical-workflows-how-franciscanmissionaries-of-our-lady-health-system-is-partneringwith-suki-to-reduce-burnout/.
2. “Suki ROI Validations 2026.”
Will Landry, FMOL Health’s senior vice president and chief information officer, describes a process many health systems are undergoing: transitioning to greater use of artificial intelligence in their facilities.
1. How are you already using AI in your workplace? What are your hopes for it? What are your concerns? Are you finding that it eliminates some administrative tasks? Is it playing a much larger role, analyzing population health matters, or helping with community benefit analysis?
2. How has your work environment introduced and explained its use of AI? Is it being used in operations, research, patient care or other aspects of your work? What is an appropriate use for it? What should never be delegated to AI?
3. Managing the rate of change can be challenging in an organization. What do you think of the suggestions Landry provides for this?
4. A central tenet of Catholic social teaching is the dignity of the human person. As healthcare organizations implement AI into patient care in order to maximize efficiency and reduce the burden on providers, what can be done to ensure that the human connection remains at the center of all interactions and relationships?
Healthcare’s Role in Managing the Environmental Toll of AI
KELLY BILODEAU Contributor to Health Progress
Artificial intelligence is poised to revolutionize healthcare, but its use, from chatbot interactions to radiology image interpretations, carries a steep energy debt that the industry is only beginning to confront.
The technology, which imitates human learning, has gluttonous power needs. It draws on the electrical grid not only to keep servers and electronic equipment humming, but also to power air conditioners and closed-loop cold water-cooling systems, said Dr. Andrea Vicini, PhD, a Jesuit and bioethics professor at Boston College. A large data center can use as much energy as 80,000 homes. It might also consume up to 5 million gallons of water a day, enough to supply a town of 10,000 to 50,000 people, depending on usage rates. If projections hold true, AI could account for 12% of electricity use in the country by 2028.1, 2
These vast demands raise questions about the hidden environmental and social costs of planned AI infrastructure projects and who will ultimately pay the astronomical energy bills. These questions will only intensify as the technology weaves its way into more ubiquitous use, driven by the rise of agentic AI, a self-sufficient iteration that can carry out tasks without continuous human prompting.
In these early days, many health systems are primarily focused on AI’s promising possibilities to support patient care and streamline operations. But they should also factor in its downsides and take a more active role in mitigating its risks, Vicini said. “We are in a situation where the tech-
nology we are going to use is worsening our mission as healthcare institutions and ultimately worsening the health of the citizens,” he said.
THE PROMISE OF AI-DRIVEN CARE
The appeal of AI in healthcare is clear. It’s uniquely suited to analyze and digest an enormous amount of medical data, detect patterns and make predictions. It doesn’t complain about taking on rote, labor-intensive tasks that bog down doctors and staff, such as note-taking during patient appointments. “We are currently using AI in ambient listening,” said Alan Sanders, vice president of ethics integration and strategy at Trinity Health. Reducing tasks like this helps free up more time for patient care, he said.
Other facilities are using AI to interpret imaging results or to scan data for early signs that a patient may be at risk for sepsis.3 It can also provide oversight, flagging errors, speeding diagnoses of rare diseases, and recommending treatments. Some organizations are already seeing signs that it can reduce burnout and medical errors in an era where many facilities are overburdened and understaffed.4
While AI is already being used in some form at most healthcare organizations, it’s still too early to say where it will ultimately find its place. “Our
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Healthcare organizations should play a role in buffering the negative effects from AI, including environmental impacts and the potential toll on vulnerable populations, Vicini said. They can do this by being strategic about their own use while also pushing for regulatory and policy guardrails.
PRUDENT MANAGEMENT
While there are some anti-AI voices who want to halt the development of the technology, Vicini sees it as an inevitability, one that should be managed to reduce harm. The Vatican, in an official doctrinal reflection on AI, Antiqua et Nova (“Ancient and New”), takes a similar view. “By exercising prudence, individuals and communities can discern ways to use AI to benefit humanity while avoiding applications that could degrade human dignity or harm the environment,” it states. “In this context, the concept of responsibility should be understood not only in its most limited sense but as a ‘responsibility for the care for others, which is more than simply accounting for results achieved.’”12
Used correctly, AI could help improve environmental stewardship, according to the United Nations. This may include broad uses, such as monitoring satellite imagery of global emissions or energy conservation support in individual homes.13 UNICEF is using AI to predict where water shortages and natural disasters like flooding may occur to enable quick responses.14
Healthcare organizations should play a role in buffering the negative effects from AI, including environmental impacts and the potential toll on vulnerable populations, Vicini said. They can do this by being strategic about their own use while also pushing for regulatory and policy guardrails. Providers should favor applications that have proven clinical benefits and lower energy needs, he said.
“I think it begins and maybe even ends with regard to what I call responsible and prudent use of AI,” Sanders said. This means asking questions about each use, he said. Do we really need it? How will it improve patient care? And what are the benefits and consequences?
Advocacy at the local, state and federal levels will be crucial as powerful, wealthy companies exert their interests, Vicini said. History is rife
with examples of corporate interests winning out over humanitarian protections, he said.
Healthcare facilities are well positioned to play an important role in helping to guide how AI use will unfold, Sanders said. As an example, Providence has taken steps in that direction by initiating conversations with service providers.
“Providence uses AI models and hosted services from trusted third-party vendors instead of hosting in its own data centers,” the organization said in a written statement. “While data providers are not currently reporting AI-related carbon emissions and water usage to us at this time, Providence continues to regularly engage partners on these issues as part of its broader environmental stewardship efforts. Our Environmental Stewardship team works diligently with all vendors to seek greater transparency and access to emissions reporting across our enterprise.”
Individual health systems and organizations can also advocate for change by reaching out to their representatives in Congress to encourage federal laws governing the use of AI, Vicini said. Currently, few federal regulations govern AI use. States have increasingly introduced their own legislation to fill the void.
In a December 2025 executive order, the White House not only confirmed its preference for a hands-off regulatory approach to AI, but also said state laws present a barrier to technological progress and to the U.S. establishing itself as a leader in this technological revolution.15 “To win, United States AI companies must be free to innovate without cumbersome regulation,” it stated. “But excessive state regulation thwarts this imperative.” Individual states may have some legal footing to push back on federal efforts to roll back laws, according to an insight from the law firm of Ropes & Gray.16
(Separately, a June executive order established a framework where some advanced AI systems could voluntarily be submitted to the federal
government for 30-day review to guard against national security risks before their release to the public.)
In addition to pushing for more AI oversight, organizations should advocate for clear policies that specify who will pay for AI-related energy costs and negative health-related effects, Vicini said. They should also back efforts to develop less harmful ways to power AI in the future, he said.
While individual organizations should establish their own guiding policies to ensure ethical use of technology, they can also consolidate their power by banding together to amplify their concerns. “Together, we can have a stronger voice in advocating for changes or regulations or raising awareness,” Vicini said.
KELLY BILODEAU is a freelance writer who specializes in healthcare and the pharmaceutical industry. She is the former executive editor of Harvard Women’s Health Watch. Her work has also appeared in The Washington Post, Boston magazine and numerous healthcare publications.
NOTES
1. Ashley J. Lawson, Martin C. Offutt, and Ling Zhu, “Data Centers and Their Energy Consumption: Frequently Asked Questions,” Congressional Research Service, May 12, 2026, https://www.congress.gov/ crs-product/R48646.
2. Miguel Yañez-Barnuevo, “Data Centers and Water Consumption,” Environmental and Energy Study Institute, June 25, 2025, https://www.eesi.org/articles/view/ data-centers-and-water-consumption.
3. Laura Cech, “AI to Detect Sepsis,” Johns Hopkins Magazine, Winter 2022, https://hub.jhu.edu/magazine/ 2022/winter/ai-technology-to-detect-sepsis/. 4. Kelly Bilodeau, “How Technology Is Reshaping Care for Older Adults,” Health Progress 107, no. 1 (2026): https://www.chausa.org/news-and-publications/ publications/health-progress/archives/winter2026/how-technology-is-reshaping-care-forolder-adults.
5. James O’Donnell and Casey Crownhart, “We Did the Math on AI’s Energy Footprint. Here’s the Story You Haven’t Heard,” MIT Technology Review, May 20, 2025, https://www.technologyreview.com/2025/05/20/ 1116327/ai-energy-usage-climate-footprint-big-tech/.
6. “The 17 Goals,” United Nations, https://sdgs.un.org/ goals.
7. Karen Hao, “Training a Single AI Model Can Emit as
Much Carbon as Five Cars in Their Lifetimes,” MIT Technology Review, June 6, 2019, https://www. technologyreview.com/2019/06/06/239031/traininga-single-ai-model-can-emit-as-much-carbon-as-fivecars-in-their-lifetimes/.
8. Liz Mineo, “Why Are Communities Pushing Back Against Data Centers?,” Harvard Gazette, April 9, 2026, https://news.harvard.edu/gazette/story/2026/04/whyare-communities-pushing-back-against-data-centers/.
9. Mark Bergen, “OpenAI Pauses Stargate UK Data Center Citing Energy Costs,” Bloomberg, April 9, 2026, https://www.bloomberg.com/news/articles/ 2026-04-09/openai-pauses-stargate-uk-data-centereffort-citing-energy-costs.
10. “Groups Appeal Air Permit for xAI’s Personal Power Plant in North Mississippi,” Southern Environmental Law Center, April 9, 2026, https://www.selc.org/ press-release/groups-appeal-air-permit-for-xaispersonal-power-plant-in-north-mississippi/.
11. “The Growing Impacts of Data Centers on Our Neighbors and God’s Creation,” Catholic Climate Covenant, March 5, 2026, https://www.catholicclimatecovenant. org/resources/the-growing-impacts-of-data-centerson-our-neighbors-and-gods-creation/.
12. Dicastery for the Doctrine of the Faith and Dicastery for Culture and Education, “Antiqua et Nova: Note on the Relationship Between Artificial Intelligence and Human Intelligence,” The Holy See, January 28, 2025, https://www.vatican.va/ roman_curia/congregations/cfaith/documents/ rc_ddf_doc_20250128_antiqua-et-nova_en.html.
13. “How Artificial Intelligence Is Helping Tackle Environmental Challenges,” United Nations Environment Programme, November 7, 2022, https://www.unep.org/ news-and-stories/story/how-artificial-intelligencehelping-tackle-environmental-challenges.
14. “AI for Climate Resilience,” UNICEF Office of Innovation, https://www.unicef.org/innovation/ ai-climate-resilience.
15. “Ensuring a National Policy Framework for Artificial Intelligence,” The White House, December 11, 2025, https://www.whitehouse.gov/presidentialactions/2025/12/eliminating-state-law-obstruction-ofnational-artificial-intelligence-policy/.
16. Stephanie A. Webster et al., “Examining the Landscape and Limitations of the Federal Push to Override State AI Regulation,” Ropes & Gray, March 11, 2026, https://www.ropesgray.com/en/insights/ alerts/2026/03/examining-the-landscape-andlimitations-of-the-federal-push-to-override-stateai-regulation.
Human beings are called to be co-workers in the work of creation, not merely passive consumers of content generated by artificial technology. Our dignity lies in our ability to reflect, choose freely, love unconditionally and enter into authentic relationships with others.”
— Pope Leo XIV’s message at a conference in Rome on “Artificial Intelligence and Care for Our Common Home” on Dec. 5, 2025
ARTIFICIAL INTELLIGENCE
AI and the Healthcare Workforce: What’s Changing?
ELIZABETH GARONE Contributor to Health Progress
Artificial intelligence is already changing the way that many healthcare providers do their jobs. In many doctors’ offices and hospitals, AI is working in the background. Computer algorithms scan X-rays and MRIs and flag any urgent issues for radiologists before they view them.1 In the intensive care unit, advanced AI-enabled software monitors patients in real time to alert nurses if there is a problem. For physicians, it can translate to no longer having to meticulously take notes while listening to their patients’ concerns, as voice tools automatically do the work for them.
These changes, among others, raise a host of questions about how AI will transform the healthcare workforce as we know it. What are the consequences for the people in these positions and the medical students hoping to get there? Will AI steal their jobs, as skeptics predict? Or can slow and steady adoption free doctors, nurses and others in the field to get back to doing what they do best: helping patients? But will all of this translate into faster but less personal care?
THOUGHTFUL INTRODUCTION AND UPDATES
AI needs to be incorporated methodically and with intention, according to Josh Clark, vice president of quality and safety operating systems for the Institute for Healthcare Improvement (IHI).
“In the best-case scenario, the physician and nursing staff spend a lot less time documenting and looking for information, and more time at the bedside taking care of patients,” he said. “But that has to happen by design; it won’t just happen on its own. As we think about giving more time back to clinicians, we need to design it so that it results in
actual patient care, and not just more and more patients seen faster because now we’re more efficient with AI.”
Clark’s concern about AI’s efficiency causing patient overload is especially worrisome to healthcare providers. The U.S. is projected to have a shortage of roughly 500,000 healthcare workers, including physicians, RNs and LPNs, by the year 2037, according to a December 2025 report by the Health Resources & Services Administration.2 So, in addition to concerns about losing their jobs to AI, they are also concerned about the potential increase in their patient loads.
“If we’re just using AI to create efficiency so we can see more patients and make more money, that’s not going to benefit the greater good,” said Clark.
Michael Kramb, SSM Health’s deputy chief people officer, believes that for healthcare organizations to be successful, “they need to treat AI as a workforce and change management strategy” and not just a tool. “AI is really pushing education and workforce deeper toward adaptability and
continuous learning,” he said.
Done right, AI will retrain people rather than replace them, said Kramb. “AI gives us that opportunity to pivot and to redeploy versus displacement. Instead of eliminating those individuals, we can actually leverage AI to skill them up: either to a different level within their current position or teach them to go into something different. We now have the education and the tools and the venue to provide them with that skill set so that they can be successful in other roles within the organization.”
The hope is that AI will reduce the burden related to tasks like documentation, allowing those working in healthcare more time to focus on their patients. Dr. Andrea Rock, a pediatric cardiologist with SSM Health in Wisconsin, uses ambient AI to record her patient appointments. “The best part is that it largely eliminates the computer between me and the patient and allows me to have more natural conversation than I have since EMR charting began, while capturing more details than paper charting or typical EMR use,” she said.
measurement domains that together capture the full spectrum of workload, environment and individual risk factors influencing well-being and retention across our clinical workforce,” she said. “The goal is not simply to surface information. The goal is to help leaders at every level use earlier insight to drive more informed decisions, better conversations and stronger retention outcomes.” SSM Health and Atalan are also building a similar tool with the organization’s nursing staff.
“The best part is that it largely eliminates the computer between me and the patient and allows me to have more natural conversation than I have since EMR charting began, while capturing more details than paper charting or typical EMR use.”
— DR. ANDREA ROCK
Schmidt says it is still early in the journey. “But this opportunity to think differently about how data can tell the story of workload burden and how it contributes to clinician well-being has the potential to be transformational.”
In Rock’s case, the use of AI saves time and gives her that chance to interact more directly with her patients — but it has its shortcomings. “The reports that are being generated are still not as clear and natural as a physician’s written thoughts,” she said, “so in some cases the clarity of communication to other doctors is not as good if I don’t supplement the AI-generated report.”
Still, the AI component is trainable around which details should be included. “At first, it would eliminate details about family, school, travel or hobbies as ‘small talk,’ but the more I work with the system, the better it does at capturing these.”
One way that SSM Health is supporting its clinicians — specifically helping to prevent burnout is through an AI-powered clinician retention and well-being dashboard being rolled out across the organization in partnership with AI technology company Atalan, according to Dr. Heather Schmidt, system medical director of employee well-being. “The clinician retention and wellbeing dashboard organizes already available data within a framework that focuses on seven core
ADAPTING EDUCATION TO AI
Medical education can be slow to adapt, and this will be difficult given the hyperspeed at which AI is being deployed and evolving, according to Clark.
“Graduate medical education changes usually take a decade. The nursing curriculum is still anchored in things that were being taught several decades ago. It also often takes six months to a year to get a new publication out,” he said. “For us to be able to identify how AI is changing healthcare delivery and react in a way that mitigates risk and maximizes benefit, we’re going to have to become more agile as an industry in education, in science and ultimately in application.”
Creighton University’s Lindsay Iverson, DNP, associate professor of nursing and director of Clinical and Simulated Environment for the Center of Interprofessional Practice, Education and Research, understands the challenge of moving education forward quickly while maintaining all necessary safeguards. She is constantly looking for new ways to challenge and support her stu-
ARTIFICIAL INTELLIGENCE
dents. These days, that is often with the help of AI.
By incorporating AI into her teaching, she has accomplished two important tasks: taking advantage of its time-saving features and introducing it to her students, as AI will become a larger part of nursing and other healthcare careers.
“I think we’re going to start to see AI in clinical settings more and more through prediction models. Is a patient at risk for falls, for bed sores?” she said. “The AI can interpret all their medications and give you a summary. And students are also using AI to help write their clinical notes in a safe, HIPAA-compliant environment to improve their note-taking and management of that patient.”
Iverson and her colleagues also carefully consider how they integrate AI into their nursing clinical education, particularly early in students’ training when they are still developing their clinical and diagnostic skills. “One concern is that if our students develop an over-reliance on AI for tasks like clinical note writing, it could potentially limit opportunities for students to fully develop their own clinical reasoning skills.” AI is not used as a replacement for thinking, but as a tool to enhance learning, she explained. “For example, students may first develop their own clinical notes and go through the diagnostic reasoning process, and then use AI to compare, refine and receive feedback on the note. This allows them to identify gaps, strengthen their clinical thinking, and improve efficiency over time,” she said.
The school has also introduced RX24, a chatbot designed to help students study and master some of nursing’s notoriously difficult subjects, such as antimicrobial pharmacology. “Students click on a link and have access to an avatar: basically, a one-on-one tutor based on the specific content. I uploaded the guidelines, past exams, past quizzes and all the PowerPoint lectures on
that specific content, so students can ask any question they don’t understand,” explained Iverson. “Instead of turning to Google or messaging me at 2 in the morning when I’m sleeping, they can access this tutor 24 hours a day, seven days a week. It will also give them multiple-choice questions based on those materials, and they can keep quizzing themselves prior to the exam.” This approach allows students to expand their skill sets and knowledge.
The school is also using chatbots to help students practice speaking with patients and their families. “Both our undergraduate and our graduate students said that they do not get enough practice navigating difficult conversations in healthcare. When they got to the clinical setting and had to deal with a patient who needed to receive some difficult news, they felt very unprepared,” said Iverson. “So, we thought, what could we do at Creighton University to prepare them, to build that competency, to build that confidence, so they could really handle those difficult conversations, whether it’s delivering a terminal diagnosis or telling a family member that their patient was in a car accident?”
All of this is helping prepare students for environments that are rapidly evolving to include more AI. “We know that our students at Creighton University are going to use AI on most things that they do. We want to prepare them to have AI literacy: to use AI safely and ethically,” said Iverson. “A lot of universities are telling students, ‘Don’t use AI.’ We’re saying, ‘Use it, see what works, see what doesn’t work, and then try to improve upon that.’ The whole point of using AI ethically is to give our students those safe learning environments so they are set up for success to use AI appropriately.”
Anna E. Price, PhD, a professor of public health in the College of Health Professions at Sacred
“A lot of universities are telling students, ‘Don’t use AI.’ We’re saying, ‘Use it, see what works, see what doesn’t work, and then try to improve upon that.’ The whole point of using AI ethically is to give our students those safe learning environments so they are set up for success to use AI appropriately.”
— LINDSAY IVERSON
Heart University, sees faculty responses ranging from full adoption to strict limits. “But most see AI as a tool with clear benefits and drawbacks. It can assist with learning, writing and test prep, but it also raises concerns, including environmental impacts and broader societal effects,” she said. “A major challenge is assessment,” she said, explaining that educators are rethinking how to evaluate genuine student understanding, not just a student’s ability to leverage AI. “For some, this is driving greater use of in-class exams, oral assessments and hands-on simulations.”
Even with the myriad challenges, AI is driving important innovation, said Price. “It encourages educators to reevaluate long-standing practices and try new teaching methods,” she said. “To do this effectively, institutions need to invest in professional development and foster open, inclusive discussions about how AI is, or is not, used in the classroom.”
PATIENTS SEEK HUMAN CONNECTION
Those same discussions are taking place outside the classroom as well, especially among patients and what they do or do not want from their providers and AI.
AI will reshape at least some of the healthcare workforce by changing roles, creating new opportunities, and potentially automating certain tasks, said Price. But one point she has found in her research is clear: “Patients do not want AI to replace their providers,” she said.
Price and her research partner, Foluke Omosun, assistant professor in Sacred Heart’s School of Communication, Media and the Arts, recently conducted a national poll with GreatBlue Research on healthcare and AI.3 Poll results showed that AI use in seeking health information is already widespread. “But the public expects transparency and choice. A large majority wants to know when AI is used, understand its role, and have the option to opt out,” she said.
According to the poll, more than one-third of U.S. adults already use AI tools to research medical topics, and 61% rely on search engines that now integrate AI responses. Americans demand transparency and choice: Nearly 88% want disclosure whenever AI is used in care, 83% believe patients should have the right to opt out of AI-driven care, and approximately 86% want AI’s role explained in plain language. The poll also found that people in the U.S. have concerns about
AI and data privacy, but they are optimistic, with more than half believing that AI can improve access to healthcare and information.
Price keeps the poll results in mind as she chooses how to integrate AI into her teaching and prepares her students for careers that are evolving because of it. She also tries to emphasize the importance of deploying AI equitably.
“Preparing students involves equipping them to collaborate effectively with AI while maintaining strong clinical judgment and ethical decision-making,” said Price. “It also requires addressing issues of equity. Variations in access to AI tools and training could exacerbate existing disparities in health and digital literacy. As AI becomes part of healthcare systems, deliberate investments in AI literacy across all communities are essential.”
Like many other educators, Price believes that AI should be understood as a tool to support care, not replace human connection. “Evidence shows that patients value and expect personal relationships with their providers, and that must remain central,” she said. “Importantly, the commitment to human dignity and whole-person care means that technology should enhance, not undermine, the clinician-patient relationship. Preserving empathy, trust and personal connection is essential.”
EMBEDDING ETHICS AND OVERSIGHT IN DECISION-MAKING
As part of SSM Health’s commitment to carefully integrate AI into the healthcare workplace, the organization established an AI Ethics and Oversight Committee in 2023. The committee is composed of people with clinical backgrounds and leaders in IT and other areas, like human resources, said Kramb.
“It’s not just about governing what type of AI technology we’re using but looking at what does work look like in the future,” he said. “We need to start asking the questions and planning for the future, because if we can leverage AI as a workforce strategy, that’s how we can be well positioned to react to the changes that we know will be coming.”
IHI’s Clark agrees; even just a couple of years in AI is an “eternity,” he said. “We’re going to have some fundamental changes in how things are being done, and we just need to be really intentional and strategic.”
ELIZABETH GARONE is a freelance writer who has covered health, business and human-interest topics. Her writing has appeared in The Wall Street Journal, The Washington Post, BusinessWeek and The Mercury News, among other publications.
NOTES
1. Hanae Armitage, “Artificial Intelligence Rivals Radiologists in Screening X-rays for Certain Diseases,” Stanford Medicine, November 20, 2018, https://med.
2. “Health Workforce Projections,” HRSA, December 2025, https://bhw.hrsa.gov/data-research/ projecting-health-workforce-supply-demand.
3. “Healthcare and AI Poll,” Sacred Heart University, November 25, 2025, https://www.sacredheart.edu/ media/shu-media/press-room-2026/SHU-2025-HealthCare-AI-Poll-ADA.pdf.
Michael Kramb, SSM Health’s deputy chief people officer, suggests in Elizabeth Garone’s article that healthcare systems should think about artificial intelligence as “a workforce and change management strategy,” and not just a tool. It’s a broader way of thinking about the technology.
1. As the use of AI in medicine becomes more mainstream, what level of AI competency should healthcare providers have? How should that competency vary by role? How can generational differences shape the approach and adoption of AI tools? How should systems respond to those differences?
2. How can AI be used to enhance patient care, rather than dehumanize it? What do you think about how it can add to people’s learning, rather than erode critical thinking?
3. Because some data analysis systems these days don’t show all their methodology, how can a system ensure it’s not introducing bias into its own research and conclusions? Should healthcare systems advocate on AI policy? What’s most pressing?
4. What is your ministry doing to ensure that there is thorough consideration of both the potential promise and peril of implementing AI tools and programs? Are mission and ethics leaders included in the discernment process?
The Innovation Imperative: Stewardship in the Age of AI
CYRIL PHILIP, MHA Vice President of Digital Ventures at Bon Secours Mercy Health and Accrete Health Partners
In the Catholic health ministry, we often speak of the “sacred encounter,” that profound moment of connection often between a caregiver and a person in need. At its core, this encounter reflects the ministry’s commitment to presence, compassion and dignity in every interaction. Protecting this encounter through compassionate bedside presence and connection is a mission-critical priority.
However, that encounter is increasingly shaped by forces far beyond the bedside. Clinicians face unprecedented administrative burden and burnout, while patients expect care that is accessible, responsive and increasingly available beyond traditional hours. Digital technologies, specifically artificial intelligence, now play a growing role in addressing these conditions, sometimes strengthening presence and connection, and sometimes eroding it.
In adopting new technology that supports the sacred encounter, the question for Catholic health systems centers on how innovation is designed, governed and scaled so that it supports caregivers and patients while remaining firmly anchored in mission. At Bon Secours Mercy Health, that question has guided how we think about innovation as an expression of stewardship, not simply modernization.
STEWARDSHIP WHILE ADOPTING INNOVATION
Across healthcare, innovation pipelines are often disconnected from front-line realities, leaving promising tools underutilized and core challenges, such as workforce strain, access gaps and care fragmentation, largely unresolved.
For Catholic ministries, this misalignment carries added weight. Stewardship is not optional; it is a moral obligation. The Ethical and Religious Directives for Catholic Health Care Services (ERDs) call leaders to make thoughtful, valuesaligned adoption of innovation a ministry responsibility, not a market afterthought.
At Bon Secours Mercy Health, we have found that this responsibility is best met when health systems take an active role in shaping how innovation is applied in care delivery. Technologies that influence clinical workflows, patient access and the caregiver experience are more likely to advance the ministry when they are developed in partnership with those who deliver care and are governed by leaders accountable for strategic and patient outcomes.
This understanding led Bon Secours Mercy Health to create Accrete Health Partners. Accrete was not built to be a venture fund that happens to sit alongside a health system, but as a platform integrated within the ministry with close connections to clinical and operational leaders, including executives, clinicians, nurses and front-line leaders responsible for delivering care and managing day-to-day operations. With this level of
alignment, Accrete’s investment thesis is driven by the system’s operators. By embedding innovation within these teams, Accrete helps responsibly scale operator-led solutions that support human dignity, clinical excellence and operational sustainability.
BUILDING PARTNERSHIPS TOWARD SOLUTIONS
The traditional venture capital model is often predicated on “disruption,” a term that can feel at odds with the stability, trust and ethics required in a healing ministry.
Innovation is most effective when it begins with a clearly articulated operational need rather than a speculative solution. Stewardship of resources demands discipline, alignment and accountability.
In response, Accrete’s approach prioritizes long-term innovation partnerships over transactional vendor relationships. Structured as a digital holding company within the system, Accrete invests in and supports early-stage digital health solutions designed to strengthen care delivery, workforce sustainability and patient access. Operating with a deliberately lean team of three under the leadership of the Bon Secours Mercy Health chief digital officer, the platform can move with agility, supporting faster decision-making and closer collaboration across the ministry. With a rapidly expanding market of potential solutions
ARTIFICIAL INTELLIGENCE
directly in shaping the solution. This approach is more selective than traditional venture models and creates alignment between investment, adoption and mission outcomes. This model ensures the system actively shapes innovation rather than reacts to it.
TWO PATHWAYS FOR PURPOSE-DRIVEN CHANGE
Accrete partners with companies in two ways: direct strategic investment and acceleration funding.
Direct investment supports innovation partners already working within clinical workflows. Capital investment is paired with a shared commitment to long-term value creation, ensuring the partnership is grounded in shared purpose and accountability. Capital investment enables the health system to share in the long-term value created as innovation partners grow in scale.
Launched in 2025, the acceleration funding model reflects a different but equally intentional approach. Instead of beginning with a technology and searching for a use case, clinical and operational leaders are empowered as the primary innovators. Leaders identify specific “pain points,” such as labor shortages, administrative friction or access gaps, and strategic capital is deployed to launch projects directly within care environments.
For Bon Secours Mercy Health, this approach has reinforced a broader lesson for Catholic systems: Capital can be used as an extension of stewardship when it is deployed with intention and restraint. By creating space to test, learn and refine innovation, this model helps ensure resources are used responsibly, in service to caregivers and patients.
Innovations are shaped through ongoing engagement with executives, nurses and physicians who use the technology in practice. This engagement creates a clear accountability framework, establishing a feedback loop that benefits both the system and its partners.
and novel technologies, Accrete serves as a connector, pairing real operational needs with technologies that leaders are prepared to shape, test and sustain.
This model is intentionally driven by the operator’s perspective. Technologies are considered only when clinical and operational leaders have identified a clear need and are prepared to engage
A defining feature of this model is ensuring the “voice of the operator” is present from day one. Innovations are shaped through ongoing engagement with executives, nurses and physicians who use the technology in practice. This engagement creates a clear accountability framework, establishing a feedback loop that benefits both the system and its partners. Partners are expected to provide high levels of responsiveness and
transparency, and issues are addressed directly and promptly, reflecting the belief that technologies influencing care delivery warrant the same level of accountability as other mission-critical decisions.
One area where this approach has had a tangible impact is in how the ministry supports its caregivers.
SUPPORTING CAREGIVER DIGNITY
Returning to the central question of how technology can support the sacred encounter, one area where this has been tested in practice is the ministry’s work with Atalan, a predictive retention technology focused on workforce stability.
When administrative overload, staffing shortages and constant task switching place sustained strain on clinicians, both caregiver well-being and the patient experience suffer. The initial use case was shaped by a simple concern: How can we recognize and respond to clinician strain earlier, before it compromises both the caregiver and the care they provide?
Bon Secours Mercy Health began with a launch of Atalan’s Clinician Retention Intelligence platform in a single regional market. Data from this platform helps leaders move beyond retrospective exit interviews and better understand operational conditions contributing to unexpected clinician departures, allowing for earlier, more empathetic intervention.
As the initial launch progressed, its value became clear in identifying clinicians who were overextended; this led to expansion into additional markets and a deeper codevelopment opportunity. Through Accrete’s acceleration funding, Atalan has begun work on a module that connects clinician retention and patient experience data in a single view.
This work reinforced a core conviction at the healthcare system: When caregivers are better supported, teams stabilize, care relationships deepen and the conditions for compassionate, dignified care are strengthened. Complementing these efforts, real-time operational data is also being used to better balance workloads across care teams, reducing last-minute staffing strain while maintaining clinical standards and team continuity.
This approach has since been applied to challenges beyond clinician retention and staffing. Bon Secours Mercy Health is using AI-assisted
LESSONS FOR THE MINISTRY: A ROAD MAP FORWARD
ForCatholic healthcare systems considering the integration of artificial intelligence into clinical operations, success is not found in mimicking Silicon Valley, but in leveraging clinical insight and operational discipline to scale what works:
The operator as innovator: Never invest in a technology without front-line leadership engagement. Innovation succeeds when it is done with clinicians, not to them.
Mission over margin: Financial sustainability matters, but alignment with mission and values must remain the primary filter.
Scale with conviction: Focus on proven solutions addressing real needs rather than speculative bets disconnected from care delivery.
nursing and virtual care models to reduce unnecessary task switching and administrative “noise.” By enabling virtual nursing support and ambient documentation capabilities that help streamline routine tasks, reduce interruptions, and return clinical time to the bedside, caregivers can focus more fully on direct patient care.
The health system also leverages agentic and conversational AI to address routine patient needs, including scheduling appointments, refilling medications and navigating care. With digital assistance in web-based chat platforms, text messaging and calls, patients can ask questions and receive trusted information in the channel that works best for them. For a patient like a low-income mother trying to schedule an appointment after her night shift ends, this technology can serve as an avenue for justice and access, extending support beyond traditional office hours and reducing barriers to timely care.
These use cases are aligned with the system’s priorities and feed into its investment and acceleration pipeline. Each initiative follows the same discipline: start with a clearly defined operational need, engage front-line leaders as partners, and scale only when the solution strengthens both mission and outcomes.
ETHICAL GOVERNANCE OF AI
Catholic health systems face a growing responsibility to address the ethical and governance questions accompanying the expanded use of AI in care delivery. At Bon Secours Mercy Health, dedicated leadership for data, analytics and AI is helping to shape a governance framework that ensures technology is deployed safely, transparently and in alignment with the ministry’s mission and the ERDs.
This work remains in its early stages, but the intent is clear: Predictive analytics and machine learning must be evaluated not only for technical performance, but through explicit ethical review addressing transparency, data stewardship, bias, privacy and the patient-clinician relationship. In addition, fiscal stewardship is a strong focus, ensuring AI capabilities of core technology platforms are maximized. At Bon Secours Mercy Health, executive leadership accountability has been explicitly established to ensure AI is responsibly deployed across the ministry.
Treating AI as morally consequential rather than neutral helps ensure innovation remains accountable to the people it is meant to serve.
SHAPING TECHNOLOGY TO PRESERVE THE HEALING MINISTRY
As the ministry looks toward the future, the integration of digital health and AI is not a departure from Catholic health traditions; it is a continuation of them. By embracing accountable innovation, the healing ministry remains both technologically capable and compassionately grounded.
The goal is not simply to invest in tools, but to invest in conditions that preserve the sacred encounter for generations to come.
CYRIL PHILIP is vice president of digital ventures at Bon Secours Mercy Health and Accrete Health Partners. Within the health system, he leads the identification and scaling of technologies that align with the ministry’s mission and operational priorities.
THE SERVICE CENTER AT SERVICECENTER@ CHAUSA.ORG
are complimentary for those who work for CHA members in the United States.
From Principles to Policy: Setting Responsible Guardrails for AI
KATHLEEN A. CURRAN, JD, MA Senior Director of Public Policy, Catholic Health Association
Artificial intelligence is rapidly changing how healthcare is experienced and delivered. The Catholic health ministry is using AI tools in countless ways to improve care, from radiology and imaging to precision medicine to surgeon-controlled AI-assisted robotics. Research is even underway to develop and test fully autonomous AI robots that can perform surgery with minimal or no spoken guidance from a human surgeon.1
While AI use in healthcare offers great advances in diagnosis, treatment and patient engagement for patients, it also poses significant ethical challenges, as illustrated by the prospect of operations conducted without a human surgeon. Overreliance on AI risks eroding both the physician’s skills and the patient-doctor relationship. If clinicians increasingly cede functions to AI, how will they, through experience, gain the judgment and skills they need to care for their patients?
The ability of AI to gather and analyze data at scales and speeds far beyond human capacity, based upon complex algorithms, means that doctors may not be able to fully explain recommended treatments. It also means that such systems can produce biased or discriminatory outcomes because of inadequate databases or algorithmic assumptions. This lack of transparency can erode trust, which is fundamental to the patientprovider relationship, and raises questions about accountability and liability. When something goes wrong, does responsibility lie with the clinician or hospital that used the AI tool, or with the developers who designed it?
These are just some of the challenges the accel-
erating use of AI in healthcare is raising. How can we best respond?
MONITORING AND EVALUATION
To address unanswered questions around AI’s use in healthcare, it is important to first come to agreement around ethical principles. Many different organizations and associations have developed principles for the ethical use of AI, including the Vatican. In 2020, the Pontifical Academy for Life organized a conference on AI that culminated in the Rome Call for AI Ethics with Microsoft, IBM, and representatives of the United Nations, the Italian government and the European Parliament. Dozens of additional private and public sector organizations have since signed on, including Catholic health systems. The document promotes principles for the ethical use of AI: transparency, inclusion, accountability, impartiality, reliability, and security and privacy.2
Both the late Pope Francis and Pope Leo XIV have been outspoken on the need for ethical, human-centered AI practices. During Pope Francis’ pontificate, the Vatican issued “Antiqua et Nova (“Ancient and New”): Note on the Relationship
Between Artificial Intelligence and Human Intelligence,” and Pope Leo’s first encyclical is focused on AI. Closer to home, this past spring, the Center for Theology and Ethics in Catholic Health issued a statement following its conference on AI ethics and Catholic healthcare, articulating seven ethical norms for the use of AI in the Catholic health ministry.3
Second, hospitals and health systems should have internal processes to evaluate which AI tools to use, how to use them, and how to monitor their effects over time. The president of a large public health system was recently quoted as saying that, once the regulatory landscape allows it, he’s ready to replace radiologists with AI in some circumstances, allowing AI to read images on its own, with human doctors only offering “second opinions” if abnormalities are detected.4 Would this be appropriate in Catholic healthcare?
Some Catholic health systems have already established internal controls. CommonSpirit Health has a multidisciplinary Enterprise Data and AI Governance committee to evaluate the ethics, data, algorithm and governance implications of AI tools. With more than 240 AI applications across the system, 5 the committee has recently gone from biweekly to weekly meetings.6 At Providence, they have two work groups for AI oversight and governance. A clinical AI work group appraises and provides feedback on clinical AI tools. The Enterprise AI Guardrails Work Group evaluates the safety, equity, legal, ethical and privacy implications of AI tools.7
There have also been attempts to establish voluntary, industrywide selfgovernance standards for AI in healthcare. An early effort was the Consumer Technology Association’s 2021 release of its ANSI/ CTA-2090 standard, The Use of Artificial Intelligence in Health Care: Trustworthiness. Another example is the Trustworthy and Responsible AI Network, launched in 2024 by more than a dozen health systems in collaboration with Microsoft.
opment and use of AI in healthcare. In 2025, CHAI partnered with the Joint Commission on an initiative to develop AI playbooks, tools and a certification program based on evidence- and consensusbased best practices for health AI. CHAI initially worked closely with the federal government during former President Joe Biden’s administration in an attempt at a public-private partnership, but the relationship ended under President Donald Trump’s administration, with an emphasis on deregulation, competitiveness and innovation.
REGULATING AI
What should the government’s role be in overseeing AI in healthcare? Existing federal health regulations already apply to AI in several ways. The Food and Drug Administration (FDA) is the most actively involved agency. The agency regulates medical devices across their lifecycle, including those using AI. As of the end of 2025, the FDA had approved more than 1,400 devices using AI, with radiology accounting for three-quarters of all approvals.8 So far, no generative AI device has been approved by the FDA, but one is under consideration: a virtual care chatbot to monitor and assist patients after joint replacement surgery.9 Because generative AI can “learn” and change over time and, depending on how a question is asked, provide different answers, it will be a challenge for the FDA to apply its usual standards, and the outcome of its review could set important industry precedents.
Hospitals and health systems should have internal processes to evaluate which AI tools to use, how to use them, and how to monitor their effects over time.
Founded in 2022, the nonprofit Coalition for Health AI (CHAI) brings healthcare organizations, tech companies, clinicians and other stakeholders together to develop guidelines for the safe, effective, responsible and innovative devel-
At the U.S. Department of Health and Human Services, the Office of the National Coordinator for Health Information Technology (ONC), the Office for Civil Rights (OCR), and the Centers for Medicare and Medicaid Services (CMS) all play policy roles with respect to AI in healthcare. ONC oversees national policy on the development and use of health IT and electronic health records, and the interoperability of health IT for data sharing. ONC gets involved in regulating AI
As AI rapidly expands, it is understandable that states are responding to the need for a regulatory structure to manage emerging risks. But if we are going to both manage risks and encourage innovation, a national approach makes more sense.
applications when they provide algorithm-based decision support within health IT systems.
OCR is responsible for nondiscrimination and patient privacy laws. The office issued regulations in 2024 that applied the Affordable Care Act’s nondiscrimination requirements to health entities’ use of clinical algorithms and AI tools. OCR also enforces the Health Insurance Portability and Accountability Act (HIPAA), which applies to AI tools that interact with protected health information when used by health providers, plans or AI vendors.
Finally, CMS determines which treatments Medicare and Medicaid will cover and reimburse, decisions that can influence what kinds of AI tools are developed and used not just in those programs but also in private-sector coverage as well. As of January 2026, CMS had approved 26 AI codes for clinical services, 23 of which were temporary new technology codes.
CMS has a Medicare pilot program to reward health outcomes in patients with chronic conditions, which encourages participants to use technology solutions such as AI diagnostics, biomarker monitoring devices and software that streamlines key workflows. It has another voluntary pilot to experiment with the use of AI to make prior authorization determinations in Medicare. CMS has not yet directly regulated or mandated the use of AI tools in care delivery, but could do so in the future, for example, by amending the hospital conditions of participation.
These examples show how existing federal policy applies to AI in an ad hoc way — there is currently no comprehensive federal AI policy that exists in healthcare or in general. And the states have stepped into the vacuum.
STATE GOVERNANCE OF AI
State activity escalated in 2025 and has surged this year. According to Manatt Health, in 2025, more than 250 bills on AI and healthcare were intro-
duced across 47 states, and in just under half of those states, a total of 34 bills were signed into law.10 By the end of April 2026, the flow of legislation had already almost outpaced the 2025 total with more than 240 bills in 43 states, and seven laws enacted in seven states.11
Colorado and California have enacted the most sweeping cross-sector consumer protection laws. The Colorado statute imposes extensive requirements on developers and deployers of “high-risk” AI systems to publicly disclose information, develop risk management policies and impact assessments, and protect consumers from algorithmic discrimination.12 The California law targets very large entities with revenues over $500 million that develop highly complex AI “frontier models” — the most advanced, largescale, general-purpose AI models — and its application to healthcare is likely to be limited.
Bills specifically addressing AI in healthcare tend to have similar themes across states.
AI chatbots are a common topic, particularly concerns about preventing harmful or inaccurate responses, their use in mental health situations and their impact on minors. Legislation on clinical uses of AI has restricted its use in making therapeutic decisions, interacting directly with patients or generating treatment plans without clinician oversight, and has mandated patient disclosure and consent when AI is used in their care. States continue to be concerned about payers’ use of AI to make medical necessity or prior authorization determinations.13
While states are seeking to regulate AI, some are also encouraging innovation by establishing “sandboxes,” environments where developers can experiment with and test various AI models and machine learning algorithms. Three states — Utah, Texas and Delaware — now have laws creating programs to exempt participants in regulatory sandboxes from legal and regulatory requirements that would otherwise apply and could stifle
innovation. Four more states have introduced sandbox legislation so far this year.14
As AI rapidly expands, it is understandable that states are responding to the need for a regulatory structure to manage emerging risks. But if we are going to both manage risks and encourage innovation, a national approach makes more sense. Some in Congress have called for, but not passed, a federal preemption law, and President Trump issued an executive order directing federal agencies to find ways to challenge state regulation. However, until federal policymakers can develop and pass legislation, simply preempting state laws leaves patients and consumers without protection.
There are signs of hope in Washington, D.C. In March, the White House released its National Policy Framework for Artificial Intelligence with recommendations for Congress on which issues warrant federal oversight and which should be left to the states. On June 2, President Trump signed an executive order focusing on cybersecurity concerns, directing federal officials to work with developers to create a voluntary clearinghouse to assess AI model vulnerabilities and to establish a classified process for prerelease review of certain new frontier models.15
In Congress, Sen. Marsha Blackburn, R-Tenn., released a draft bill that reflects several of the administration’s priorities. Republican members of the House Committee on Energy and Commerce voted out a package of children’s online safety bills, including H.R. 7757 (the KIDS, Kids Internet and Digital Safety, Act) and H.R. 6489 (the SAFE BOTs, Safeguarding Adolescents From Exploitative BOTs, Act), establishing AI chatbot guardrails for transparency and disclosure, protecting minors, and requiring chatbots to provide referral to mental health crisis resources. House Democrats have formed the Commission on AI and the Innovation Economy to work with
tech leaders, stakeholders and Congressional committees of jurisdiction to develop national policy proposals across a range of sectors, including healthcare.
A CALL TO LEAD
Ten years ago, AI was practically science fiction. Today, it is omnipresent, touching most aspects of our lives. It offers great promise to expand access to healthcare, accelerate cures, resolve health disparities and manage disease. But we must also identify and mitigate its potential harms. To do that will take the efforts of developers, clinicians, healthcare organizations and government at the state and federal levels. We need adequate government regulation, but to get the policy right, we must get the principles right, not just the tech. That’s where Catholic healthcare can be a leader, by articulating principles grounded in human dignity and a true anthropology of the person, developing governance structures, deploying personcentered use cases, and advocating for policies that protect patients while enabling innovation.
KATHLEEN A. CURRAN is senior director, public policy, for the Catholic Health Association, Washington, D.C.
NOTES
1. “AI in Hospitals: 2025 Adoption Trends & Statistics,” IntuitionLabs, May 17, 2026, https://intuitionlabs.ai/ articles/ai-adoption-us-hospitals-2025.
2. “The Call,” RenAIssance Foundation, https://www. romecall.org/the-call/.
3. Daniel J. Daly, “Statement from the ‘Artificial Intelligence, Authentic Mercy: Navigating AI Ethics in Catholic Health,’ Conference–March 21, 2026,” Center for Theology and Ethics in Catholic Health, https://site.chausa. org/docs/default-source/ctech/ctech-conferencestatement-with-signatures-3-25-final.pdf.
Ten years ago, AI was practically science fiction. Today, it is omnipresent, touching most aspects of our lives. It offers great promise to expand access to healthcare, accelerate cures, resolve health disparities and manage disease. But we must also identify and mitigate its potential harms.
4. Marty Stempniak, “CEO of America’s Largest Public Hospital System Says He’s Ready to Replace Radiologists with AI,” Innovate Healthcare, March 31, 2026, https://radiologybusiness.com/topics/artificialintelligence/ceo-americas-largest-public-hospitalsystem-says-hes-ready-replace-radiologists-ai.
5. Naomi Diaz, “CommonSpirit Expands AI to 242 Tools with Strong Governance,” Becker’s Hospital Review, February 5, 2026, https://www.beckershospital review.com/healthcare-information-technology/ ai/commonspirits-ai-footprint-grows-to-242deployments/.
6. Alex Kacik, “Why AI Tests Clinician Trust—and How Providers Are Responding,” Modern Healthcare, April 10, 2026, https://www.modernhealthcare.com/providers/ mh-medstar-health-commonspirit-ai-oversight/.
7. Sara Vaezy, “Artificial Intelligence with a Purpose at Providence,” Health Progress 106, no. 4 (2025): https://www.chausa.org/news-and-publications/ publications/health-progress/archives/fall-2025/ artificial-intelligence-with-a-purpose-at-providence.
8. “FDA’s AI Medical Device List: Stats, Trends & Regulation,” IntuitionLabs, March 13, 2026, https://intuitionlabs.ai/articles/fda-ai-medical-device-tracker.
9. Katie Palmer, “FDA Grants ‘Breakthrough’ Sta-
tus to Generative AI Chatbot for Surgical Patients,” STAT, March 3, 2026, https://www.statnews. com/2026/03/03/fda-breakthrough-designationgenerative-ai-chatbot-recovryai/.
10. Randi Seigel et al., “2025 AI Policy and Health Care Priorities In Review: What Was Hot; What Was Not,” Manatt, December 16, 2025, https://www.manatt.com/ insights/newsletters/2025-ai-policy-and-health-carepriorities-in-review-what-was-hot-what-was-not.
11. Randi Seigel et al., “Manatt Health: Health AI Policy Tracker,” Manatt, April 9, 2026, https://www. manatt.com/insights/newsletters/health-highlights/ manatt-health-health-ai-policy-tracker.
12. The Colorado bill has been controversial. Its effective date was pushed back to June 2026 because it has been challenged in court, and lawmakers are working on a compromise version.
13. Seigel et al., “Manatt Health: Health AI Policy Tracker.”
14. Seigel et al., “Manatt Health: Health AI Policy Tracker.”
15. “Executive Order 14409 of June 2, 2026, Promoting Advanced Artificial Intelligence Innovation and Security,” GovInfo, June 5, 2026, https://www.govinfo.gov/ content/pkg/FR-2026-06-05/pdf/2026-11415.pdf.
In a time of rapidly evolving artificial intelligence, Pope Leo XIV’s encyclical Magnifica Humanitas reminds us to preserve compassionate human connection at the heart of healing. CHA looks forward to continuing this conversation to ensure that innovation honors human dignity and the common good.
“We can embrace the technological progress that alleviates suffering and unlocks new possibilities, provided that we do not abandon the very essence of our humanity, namely the capacity for relationship and love.”
— POPE LEO XIV’S MAGNIFICA HUMANITAS
(MAGNIFICENT HUMANITY)
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MISSION
THE SOUND OF THE GENUINE: A CALL TO HUMAN DIGNITY
Irecently overheard a concerning conversation between two people who disagreed over a news story. Their arguments were valid. They passionately represented differing perspectives. But as their dialogue shifted into debate, curiosity disappeared. They were no longer listening. In that moment, they forgot their relationship was one of deep, personal knowing, and instead, invisible lines were drawn — each assigning a partisan label to the other. Walls rose quickly. Fellowship felt impossible.
In today’s politically supercharged society, I imagine this scenario resonates with you. Perhaps you have been an observer. Or perhaps you’ve found yourself in a similar situation with someone who didn’t see the issue the way you did. Chats like these between two people, each bringing their unique experiences and opinions, can quickly become a threeway fork in the road.
One option is to maintain a posture of open dialogue, attempting to see and hear the other, uncovering points of connection and humanity in the exchange, and at best, strengthening the relationship. Another option is to masquerade as a present listener — appearing open while quietly withdrawing one’s receptivity to the other’s humanity. A third option is to walk away, sometimes physically, or often, locating the nearest conversational off-ramp to slough off the other’s vantage point. In moments like these, disagreement itself is not the crisis; the loss of human dignity is. There is a thin line between disagreement and depersonalization.
As leaders, we know mission statements uplift our commitment to human dignity, and our values guide us on how it must look. We follow the way of Jesus and the founders of Catholic healthcare organizations to serve in love as good neighbors. In doing so, we represent the Church’s ministry through compassion and community.
But the inward work of honoring human dignity as ministry leaders begins within. How we show up before the “other” has a profound impact on our teams, our ministries, the Church and society. Knowing who we are — not merely what
we believe — has the power to transform how we honor human dignity.
TUNING OURSELVES TO RESONANCE
Shortly after witnessing the conflicted conversation, I encountered a life-altering baccalaureate service speech delivered in 1980 by theologian and civil rights activist Howard Thurman at Spelman College. Entitled “The Sound of the Genuine,” Thurman’s charge to students, during the rumble of their lives, was to be still long enough to hear the genuine within themselves: “There is in every person, something that waits and listens for the sound of the genuine in herself. … Nobody like you has ever been born. … And no one like you would ever be born again.” 1 According to Thurman, knowing one’s unique life as a gift to the world is a treasure that takes slowing down to discover.
In an age of polarization, Thurman, who was a spiritual mentor to Rev. Martin Luther King Jr., offers a spiritual antidote rooted not in strategy, but in human dignity:
“Now if I hear the sound of the genuine in me, and you hear the sound of the genuine in you, it is possible then for me to go down in me, and come up in you. So that when I look at myself through your eyes, having made that pilgrimage, I see in me what you see in me. And the wall that separates and divides will disappear. And we will become one, because the sound of the genuine makes the same music.”
In conflict, we forget that we carry the Divine spark within us. And we certainly forget the Divine spark of the “other.” This inner remembrance matters, for it changes the atmosphere into one in which God is still present. I wonder
JILL FISK
“
“Now if I hear the sound of the genuine in me, and you hear the sound of the genuine in you, it is possible then for me to go down in me, and come up in you.”
— HOWARD THURMAN
what it might have been like if Thurman’s words were spoken over my two friends. I wonder what might have shifted if his words had framed that moment — if curiosity had replaced defensiveness, if voices had lowered, if love had remained possible.
THE COURAGE TO LISTEN
Living, and for some, leading, in a way of love rooted in nonviolence, peace and a neighborfirst attitude requires personal sacrifice. Through Thurman’s mentorship, King embodied this kind of living and leading. The world yearns for leaders who know the sound of the genuine within themselves and are willing to listen for it in the lives of others — neighbors, patients, co-workers and family members. Polarization and partisanship muffle the sound of the genuine; they reward self-
protection and normalize walls that divide.
May we, as leaders and neighbors, resist the noise long enough to listen — and have the courage to lead others to do the same. May we relentlessly pursue mentors, thinkers and theologians who will call us to listen, especially to the sound of the genuine. I am convinced this is the courageous, prophetic leadership most needed now. May we slow down long enough to hear.
JILL FISK, MATM, is director, mission services, for the Catholic Health Association, St. Louis.
NOTE
1. “The Sound of the Genuine (Baccalaureate Ceremony) (Spelman College), 1980 May 4,” The Howard Thurman Digital Archive, https://thurman.pitts.emory.edu/items/ show/838.
THE FUTURE OF OLDER ADULT SERVICES IN A TIME OF DISRUPTION
HOWARD GLECKMAN
The U.S. is at a critical inflection point in its care for older adults. Demographic challenges are colliding with pressures to control costs, politics are increasingly at odds with economics, and the healthcare system is struggling to understand how it should interact with the social supports many older adults need.
Recent policy decisions are further weakening an already fragile system of services for the aging. And costs for both medical and long-term care continue to rise, even as households and the government are under financial stress.
The overarching question is: Do we try to rebuild a system of care that is already failing? Or, instead, should we reimagine how medicine, social supports, housing and family finances can be brought together to maximize the well-being of older adults?
To address this dilemma, it is important to understand the significant challenges involved in delivering the supports and services our nation’s aging population needs. These issues and growing stresses on healthcare, housing and social services call for major changes to our fragmented care model that will allow older adults to age with dignity and compassion.
CHALLENGES OF CAREGIVING IN THE U.S.
The challenge is immense: The U.S. — along with the rest of the developed world — faces an exploding population of older adults, many living with chronic conditions. The oldest baby boomers are reaching age 80, and the fastest-growing population in the U.S. is the cohort of 85-year-olds.1 This is critical because, while health remains relatively stable for the “young old” (those now in their 60s and early 70s), it begins to decline rapidly after age 75.2
Long-term care, or long-term services and
supports (LTSS), is the assistance people with chronic conditions need to live their best possible quality of life. It is not medical treatment but complements healthcare. It is often described as assistance with activities of daily living, such as personal care and nutrition, but more broadly also may include managing finances, social interactions and even appropriate housing.
Family caregivers remain the bedrock of the U.S. care system. More than 80% of those receiving long-term care live in the community rather than in senior living facilities.3 About two-thirds of them are cared for only by family members and friends, with no paid assistance.4
As the number of older adults grows, the supply of family and paid caregivers can’t keep up. The ratio of family caregivers to those who need assistance is shrinking. A simple example: In the U.S. in 2010, there were seven people of prime caregiving age (those between ages 45-64) for every person aged 80 or older. By 2030, there will be four, and by 2050, three.5
And that does not account for population mobility, which results in parents and their adult children living in distant cities. Among those aged 75 and older, nearly one-quarter of men and more than 40% of women live alone.6
Those family members who do care for their loved ones often pay a significant physical, emotional and financial price. They run a high risk of back injuries and depression. And as many as 1 in 5 working family caregivers reduce their
hours. Others take leaves, quit their jobs or retire early.7 By one estimate, a woman who leaves her job to care for a family member will lose more than $200,000 in lifetime income.8
The growing shortage of paid aides increases the burden on family caregivers. One study finds the demand for care workers in the U.S. will exceed supply by 151,000 in 2030 and by 355,000 by 2040.9
Many aides left the industry during the COVID-19 pandemic. Others are retiring from physically difficult work. More than 40% of personal care aides are aged 50 or older.10
This trend is exacerbated by the current administration’s immigration policies. Before the ongoing immigration crackdown, close to onethird of care workers were immigrants.11 Now, at least 1.4 million fewer immigrants live in the U.S. than in January 2025,12 likely making care worker shortages more severe.
Finally, care for older adults and others with chronic conditions is deeply fragmented. Even in an era of near-ubiquitous electronic medical records, communication among physicians — and with patients and their families — often is wanting. 13 Critical continuity of care may be lost when patients are transferred among hospitals, skilled nursing facilities and home.
The
GROWING BUDGET PRESSURES
Housing also plays a critical role in supporting older adults.
Because Medicaid pays for room and board only in nursing facilities, it steers frail older adults to that high-cost care setting. Medicaid cuts enacted in 2025 are likely to further shift Medicaid home and community-based care, an optional benefit, to nursing home care, which states must provide.
For those with low incomes who can live independently, the U.S. has a system of affordable, subsidized housing, though it is woefully underfunded. At the same time, the U.S. faces an enormous gap in middle-income housing for those who may benefit from limited support. For example, there are no incentives for owners/developers to provide routine health screenings or place social workers in buildings with large numbers of middle-income older adults.
The U.S. faces these multiple challenges against the backdrop of rapidly growing federal budget deficits and the rising costs of healthcare, a significant contributor to both public and private expenditures.
growing shortage of paid aides increases the burden on family caregivers. One study finds the demand for care workers in the U.S. will exceed supply by 151,000 in 2030 and by 355,000 by 2040.
These gaps are even more severe when a patient requires longterm services and supports, which require a high level of integration between two siloed care systems. Hospital discharge planners are often illequipped and time-constrained to provide useful information about post-acute care. Most physicians have little knowledge and few financial incentives to advise their patients about personal care needs.
In general, the government payment system struggles to recognize how LTSS can improve seniors’ health and potentially reduce medical costs. And even when it does, the system suffers from what economists call the “wrong pocket problem.” For example, a state may spend to improve its Medicaid LTSS program, but generally will not share in any Medicare cost savings from those initiatives.
The U.S. spends nearly 20% of its economy on healthcare. Medicare, Medicaid and Social Security, the largest programs that support older adults and younger people with disabilities, account for more than half of all federal government spending, excluding interest on the debt.14
In that environment, support for seniors inevitably will face growing budget pressures in the coming years.
RETHINKING CARE MODELS
How can we address these complex and potentially costly challenges?
It will be critical to think broadly and creatively about a future system of care for older adults with significant medical and personal care needs. And as we consider these reforms, it is important to keep in mind that delivery and financing are
inextricably linked. Without sufficient funding, public or private, no reforms are likely to succeed.
Start with the biggest payer: Medicaid. To be eligible for Medicaid LTSS, people need to have very low incomes and few financial assets and, broadly, need a nursing home level of care, though qualifications vary widely by state.
Despite spending more than $200 billion annually on LTSS,15 Medicaid often provides insufficient care to meet the needs of its enrollees. At the same time, it is difficult to coordinate a fragmented payment system in which Medicaid funds personal care and Medicare pays for medical care.
That leads to a key question: Do we want to continue building an LTSS system primarily on an income-based program, such as Medicaid, or shift to an insurance model for all but those with the lowest incomes?
A second question: Are there ways to better integrate today’s deeply fragmented care model? The U.S. could do this in several ways: Shift some government spending from medical care to LTSS. This rebalancing of priorities would bring the U.S. more into line with other major developed countries.
Expand Medicaid funding. This could make Medicaid LTSS more robust, but would add to government costs and require reversing recent policy changes that limited access to the program. In addition, it would not break down the existing silos between Medicaid and Medicare.
Create a new Medicare LTSS benefit. In recent years, Medicare has made small changes in that direction. For those enrolled in traditional Medicare, it is providing caregiver support and care navigation for the first time, though only through limited demonstration programs.
One example is CMS’s Guiding an Improved Dementia Experience (GUIDE) Model, which supports families of people living with dementia. Medicare also developed other demonstrations that would give financial incentives to providers for including LTSS-like services in medical practices and health systems. For example, the updated Long-term Enhanced Accountable Care Organization Design (LEAD) model encourages participating medical practices to develop interventions to prevent falls, a step that could include a range of nonmedical services, such as home modifications, better nutrition and family caregiver education.16
CMS has also created opportunities for more
robust LTSS through managed care, such as Medicare Advantage and Special Needs Plans, and through the Program of All-Inclusive Care for the Elderly (PACE), which is funded through both Medicare and Medicaid. This concept could be significantly expanded by creating a separate Medicare LTSS benefit. However, this step would likely increase federal spending or premiums, which are already substantial.
Establish a public long-term care insurance program. Washington state has enacted such a program, which provides an immediate benefit of up to $36,500. It is fully funded with a payroll tax of about 0.6% and has started paying benefits this July.
Several other states, including California, Minnesota, Massachusetts and Illinois, are exploring their own state-based LTSS financing programs.
A second option would be federal long-term care insurance. One bill, the Well-Being Insurance for Seniors to be at Home (WISH) Act, has modest but bipartisan support in the House. Unlike the Washington state program, it would create universal catastrophic insurance that provides partial lifetime support after a possible waiting period of one or two years. WISH is also intended to be fully funded, although key details remain unresolved (I advise on technical aspects of this bill).
The catastrophic model could lower Medicaid LTSS spending by as much as one-third over the long run. However, a universal, fully funded program would require some form of tax increase, which many in Congress would resist.
Any of these changes would be deeply disruptive to providers who have built their business models around the existing payment system. The challenge will be for them to help develop reforms that are financially sustainable and align with the mission of improving the lives of the older adults they serve.
HOWARD GLECKMAN is a nonresident fellow at the Urban Institute, where he is affiliated with the Health Policy Center and the Urban-Brookings Tax Policy Center.
NOTES
1. “Rising Demand for Long-Term Services and Supports for Elderly People,” Congress of the United States Congressional Budget Office, June 2013, https:// www.cbo.gov/sites/default/files/cbofiles/
attachments/44363-LTC.pdf.
2. Foster Stubbs, “Health Reaches an Individual ‘Tipping Point’ Around Age 75, Study Finds,” McKnight’s Long-Term Care News, December 3, 2025, https://www. mcknights.com/news/health-reaches-anindividual-tipping-point-around-age-75study-finds/.
3. “Rising Demand for Long-Term Services and Supports for Elderly People.”
4. “Selected Long-Term Care Statistics,” Family Caregiver Alliance, https://www.caregiver.org/resource/ selected-long-term-care-statistics/.
5. Donald Redfoot, Lynn Feinberg, and Ari Houser, “The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers,” AARP Public Policy Institute, 2013, http://resource.nlm.nih.gov/101624602.
6. Paul Hemez and Chanell Washington, “Living Arrangements Varied Across Age Groups,” United States Census Bureau, May 30, 2024, https://www.census. gov/library/stories/2024/05/livingarrangements.html.
7. AARP and National Alliance for Caregiving, “Caregiving in the U.S. Research Report,” AARP, July 2025, https://www.aarp.org/ content/dam/aarp/ppi/topics/ltss/ family-caregiving/caregiving-in-us-2025. doi.10.26419-2fppi.00373.001.pdf.
8. Richard W. Johnson, Karen E. Smith, and Barbara A. Butrica, “Lifetime EmploymentRelated Costs to Women of Providing Family Care,” Urban Institute, February 2023, https://www.urban.org/sites/default/files/ 2025-02/Lifetime-caregiving-costs.pdf.
9. “Understanding the Direct Care Workforce,” PHI, https://www.phinational.org/ policy-research/key-facts-faq/.
10. Priya Chidambaram et al., “Who Are the Direct Care Workers Providing LongTerm Services and Supports (LTSS)?,” KFF, October 30, 2024, https://www.kff.org/ medicaid/who-are-the-direct-care-workersproviding-long-term-services-and-supportsltss/.
11. “Immigration and the Direct Care Workforce,” PHI, March 31, 2025, https:// www.phinational.org/immigration-and-thedirect-care-workforce/.
12. Stephanie Kramer and Jeffrey S. Passel, “What the Data Says About Immigrants in the U.S.,” Pew Research Center, August 21, 2025, https://www.pewresearch.org /short-reads/2025/08/21/key-findingsabout-us-immigrants/.
13. Steve Alder, “Effects of Poor Communication in Healthcare,” The HIPAA Journal, January 2, 2026, https://www.hipaajournal. com/effects-of-poor-communication-inhealthcare/.
14. “Mandatory Spending in Fiscal Year 2024: An Infographic,” Congressional Budget Office, March 20, 2025, https://www.cbo.gov/publication/61182.
15. Alexandra Carpenter et al., “Trends in Users and Expenditures for Home and Community-Based Services as a Share of Total Medicaid Long-Term Services and Supports Users and Expenditures, 2023,” Centers for Medicaid & Medicaid Services, October 17, 2025, https://www.medicaid.gov/medicaid/ long-term-services-supports/downloads/ ltss-rebalancing-brief-2023.pdf.
16. Howard Gleckman, “Medicare to Pay Docs to Reduce Falls by Seniors While WH Curbs Other Efforts,” Forbes, March 25, 2026, https://www.forbes.com/sites/ howardgleckman/2026/03/25/medicare-topay-docs-to-reduce-falls-by-seniors-whilewh-curbs-other-efforts/.
Faith Community Nurses Networking Call
July 21 | 1 – 2 p.m. ET
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July 23 | 1 – 2 p.m. ET
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Aug. 5 | 11 a.m. – 12:30 p.m. ET
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Aug. 27 | Noon – 1 p.m. ET
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Sept. 17 | 1 – 2:15 p.m. ET
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KNOWING MORE MEANS DOING BETTER: DATA, TECHNOLOGY AND THE FUTURE OF COMMUNITY HEALTH IMPROVEMENT
When the Affordable Care Act codified community health needs assessments (CHNAs), most nonprofit hospitals were working from a relatively thin deck of data cards: census, state vital statistics and a community survey, if the budget allowed. The picture of a community’s health was impressionistic at best — a few broad strokes applied every three years and quickly dated.
The data landscape available to community benefit professionals today bears little resemblance to that of a decade ago. Nationally curated datasets on social determinants of health, nearreal-time local information from community health workers and social service providers, geographically precise population-level indicators, and platforms purposely built to synthesize it all have transformed what is possible in the virtuous cycle of assessment to implementation to evaluation. At the same time, the arrival of artificial intelligence is reshaping both what is possible and what Catholic health ministry leaders must guard against.
HOW HEALTH DATA HAS CHANGED
The classic CHNA data stack drew heavily on sources with inherent lag. The decennial census, American Community Survey five-year estimates, county-level mortality files and state behavioral risk factor surveys are invaluable. However, they describe a community as it was, not necessarily as it is; a CHNA in 2019 might have been working from observations collected as early as 2012. For rapidly changing communities — those absorbing new immigrant populations, experiencing economic shifts, or recovering from the COVID-19 pandemic — that lag matters.
Three structural changes have begun to close
that gap.
First, the proliferation of secondary data platforms has enabled the assembly of a far richer picture without replicating expensive primary research for every assessment cycle. Tools have layered economic mobility, environment and social factors onto traditional health metrics. Platforms designed specifically for community health work integrate dozens of these sources into a single, queryable environment. This allows planners to move from a broad, county-level view down to a census tract or even a block group without changing tools.
Second, the geographic granularity of available data has improved substantially. Earlier CHNAs often had to characterize entire counties or multicounty service areas as a single unit. Today’s platforms can break down data by ZIP code, census tract or neighborhood — revealing pockets of need that aggregate statistics obscure. A community that appears healthy at the county level may contain a census tract where life expectancy trails the national average by a decade. Identifying and prioritizing this geography is now a tractable data problem rather than an expensive research project.
Third, community-sourced and real-time data inputs have grown. Electronic health records (EHRs), community health worker encounter
WILL SNYDER and ANGIE GROVER
data, surveillance data and social service referral systems generate ongoing information about unmet needs that supplement the periodic snapshot of a formal CHNA. Plus, the cost of running a survey or collecting qualitative data through interviews and focus groups has decreased significantly.
When these streams are connected, organizations can monitor whether implementation strategies are reaching the right populations in the right quantities — and make adjustments before the next three-year cycle requires it.
ASSESSMENT, IMPLEMENTATION AND EVALUATION
The best community health work treats the CHNA and community health improvement plan (often known as CHIP or implementation strategy) as a continuous loop, with evaluation data feeding back into both implementation plan refinement and the next assessment.
Data platforms support this loop most effectively when they are configured to do three things simultaneously: describe the community (assessment), track progress against prioritized interventions (implementation monitoring), and measure impact over time (evaluation). The distinction between these functions matters. A platform optimized purely for CHNA production — generating a rich community profile report — may offer little infrastructure to track whether a diabetes prevention program is reducing hemoglobin A1C (HbA1c) levels in the ZIP codes where it operates. Organizations should ask, when evaluating data tools, how well they support the full cycle rather than any single phase.
Implementation monitoring is arguably the most underdeveloped of the three. Many organizations can describe a community’s needs in considerable detail and can report the dollars spent on community benefit programs. Fewer can confidently demonstrate that those programs are reaching the highest-need populations, at the right intensity, and producing measurable health change. This is partly a data infrastructure problem and partly an organizational capacity problem — but it is also, increasingly, a solvable one.
Evaluation frameworks that draw on the same community data used in the CHNA allow organizations to assess not just outputs (number of people served, services delivered) but outcomes (changes in health indicators, reductions in preventable emergency department visits, im-
provements in self-reported health status) in the geographies and populations targeted by implementation strategies. When an organization can show that its community health worker program is concentrated in census tracts with the highest rates of uncontrolled hypertension and that those tracts are showing measurable improvement, it tells a fundamentally different and more compelling community benefit story.
UNDERSTANDING AI IS INCREASINGLY NECESSARY
AI has arrived in community health data work. Understanding where it genuinely helps and where it requires disciplined caution is now a core competency for anyone responsible for a CHNA or community benefit program.
On the positive side, AI makes several previously burdensome tasks substantially more tractable. Natural language processing tools can scan thousands of pages of community input, including focus group transcripts and interview notes, and surface recurring themes far faster than human reviewers. This is particularly valuable in the community engagement phase of a CHNA, where qualitative input is often rich but underused because limited resources prevent thorough analysis.
Predictive analytics offer another area of real value. Machine learning models trained in clinical and community data can identify populations at elevated risk for specific conditions — including diabetes complications, preventable hospitalizations and housing instability — before those risks become crises. For hospitals with strong EHR infrastructure and community partnerships, this kind of risk stratification can direct community health workers’ time toward the people most likely to benefit from intervention.
AI also accelerates the synthesis of complex, multisource datasets. A platform using AI-assisted analysis can identify correlations across dozens of community indicators that a human analyst would struggle to detect. For example, it can flag unexpected relationships between building violations and pediatric asthma rates at a geographic level that is actionable. For organizations without dedicated epidemiologists on staff, this capability levels the playing field considerably.
AI RISKS LEADERS MUST EVALUATE
The same capabilities that make AI valuable in community health work also introduce risks that organizations grounded in Catholic social
teaching should take especially seriously.
Algorithmic bias is the most documented risk.1 AI models trained on historical health data will, without careful oversight, amplify existing disparities. A predictive model trained on claims data from a predominantly insured population may underidentify risk in uninsured communities that access care differently. This is not a theoretical concern: Researchers have documented cases where widely used clinical algorithms embedded racial bias into care recommendations, with real consequences for patients.2
For community benefit professionals, the practical implication is that AI-generated insights should be treated as inputs to human judgment, not substitutes for it. When a platform flags a census tract as low-priority based on aggregated indicators, that designation should prompt questions such as, “Who lives there, and are their needs captured by this data?” rather than trigger an automatic resource allocation decision.
A related risk is data quality and representativeness. AI is only as good as the data on which it is trained and applied. Communities that are least well-served by the healthcare system are often least well-represented in the data sources that AI systems draw upon. Rural populations, recent immigrants, people experiencing homelessness, and communities with low rates of formal healthcare utilization may appear healthier in data-driven analyses simply because their encounters with the health system are infrequent. AI tools that promise to identify needs must be evaluated carefully for how they handle data gaps and sparse populations.
Privacy and consent represent a third area of concern. The more granular and personalized the data underlying a community health analysis, the more important it is to be certain that individuals whose information is included have meaningfully consented to its use. Organizations should establish clear governance frameworks — specifying who owns community health data, how it is stored and protected, and what uses are authorized — before deploying AI-enabled tools that depend on sensitive information.
Finally, there is the risk of what might be called data displacement: the substitution of quantitative analysis for community voice. The richest AI-assisted CHNA is no substitute for genuine engagement with the people whose health is at stake. Communities, especially those that have historically experienced research as an extraction rather than a partnership, may be reasonably
skeptical of AI-driven conclusions about their needs. Preserving robust, trust-based community engagement processes, including qualitative listening, co-design of priorities and transparent communication of how data is used, remains essential even as the analytical sophistication of CHNA tools advances.
ACTING RESPONSIBLY, ETHICALLY
For the Catholic health ministry, community benefit is an expression of the conviction that health is a fundamental human right. That conviction does not change as the tools available to act on it evolve.
What changes is the standard of stewardship. When data is limited, organizations can be excused for gaps in knowledge about community needs. When data is abundant and analytical tools are powerful, the obligation to know and to act on that knowledge equitably rises accordingly. The communities most in need of health investment are increasingly visible in the data if organizations choose to look and have the infrastructure to see.
The data revolution in community health is ultimately not a technological story. It is a story about whether institutions with the resources and the mission to improve community health are willing to use the best available tools with appropriate humility, listen carefully as they analyze, and hold themselves accountable to outcomes rather than activities. That has always been the standard. The tools to meet it have simply gotten better.
WILL SNYDER is co-founder and CEO of Metopio. ANGIE GROVER is co-founder and chief operating officer of Metopio. Metopio is a software and data company focused on population and place-based analytics.
NOTES
1. Laura J. Horsfall et al., “Clinical Algorithms and the Legacy of Race-Based Correction: Historical Errors, Contemporary Revisions and Equity-Oriented Methodologies for Epidemiologists,” Clinical Epidemiology 17 (2025): https://doi.org/10.2147/CLEP.S527000.
2. Ziad Obermeyer et al., “Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations,” Science 366, no. 6464 (2019): https://doi.org/10.1126/ science.aax2342; Shyam Visweswaran et al., “Online Database of Clinical Algorithms with Race and Ethnicity,” Scientific Reports 15, no. 10913 (2025): https:// doi.org/10.1038/s41598-025-94152-5.
DOES IT COUNT AS COMMUNITY BENEFIT? WE’VE GOT ANSWERS.
Explore a library of frequently asked questions to help you determine whether a program or activity qualifies as community benefit. Still unsure? Submit your question online.
THE UPDATED ERDs AS CATALYST FOR ENGAGEMENT ON MEDICAL, ETHICAL QUESTIONS
In the months since the release of the seventh edition of the Ethical and Religious Directives for Catholic Health Care Services (ERDs), CHA has engaged with ethicists and mission leaders across the ministry to better understand how these revisions are being received and applied. These conversations revealed something important: The seventh edition’s impact lies less in what changed and more in the opportunity it has created for reengagement.
Across the membership, three areas of particular notice have emerged. First, the seventh edition has created an opportunity to reengage staff in meaningful formation. Second, it has prompted renewed dialogue with local bishops. Third, it has started a broader discussion about whether the ERDs themselves can evolve more rapidly to address the ever-changing healthcare environment.
MOMENT FOR RENEWED REFLECTION
One of the clearest outcomes of the seventh edition has been a renewed focus on formation. In many organizations, the release of a new edition has served as a natural starting point for revisiting a document that can too easily get lost in daily operations.
ERD education can often be treated as a compliance exercise — necessary, important and occasionally urgent, but not always fully integrated into organizational life. The seventh edition has challenged that pattern. Leaders are taking this opportunity as an invitation for their clinicians, administrators and board members to rediscover the moral framework that guides Catholic healthcare.
The revisions themselves provide useful entry points for this kind of engagement. Clarifications around emerging issues, including care for people experiencing gender dysphoria, cooperation with illicit procedures, support for pregnant women,
and end-of-life considerations, create opportunities for learning. These new discussions and educational resources can be based on reemerging questions, such as: Why has the Church spoken more clearly about this topic? What underlying principles are being applied? How do these principles shape the care we provide? Why is this topic just now being included in the document? What has changed in Church teaching since the last revision?
In this sense, the most significant impact of the seventh edition may be its ability to prompt questions rather than simply deliver answers. For leaders, the task is to ensure that these questions are taken up intentionally, forming a culture in which ethical reflection is both expected and supported. Such a culture of discernment helps our ministry to provide high-quality care that promotes the flourishing of our patients and caregivers.
DEEPENING ECCLESIAL RELATIONSHIPS
A second area of impact has been the renewed engagement between Catholic health systems and their local bishops. While this relationship has always been essential, the release of a new edition provides a natural occasion to revisit it.
In practice, this has meant new substantive conversations. Rather than focusing solely on the text of the ERDs, these dialogues have explored how the directives are lived within health systems. Systems are showing their local ordinaries how they are educating and forming their care providers and employees about the subjects addressed in the document.
For bishops, these conversations offer a win-
NATHANIEL BLANTON HIBNER
dow into the realities of modern healthcare. For system leaders, they provide an opportunity to articulate how mission and ethics are applied, not only in policy but in practice.
The seventh edition also highlights the collaborative nature of healthcare ethics. The directives themselves were developed through consultation with bishops, theologians and healthcare professionals. That same spirit of collaboration is now being extended into their implementation. Many members shared how they worked with their local bishops to align language about the changes for public announcements, promulgation and ongoing messaging. As this document is read beyond the walls of Catholic healthcare, a well-defined campaign can help the general public understand the ministry’s commitment to its mission and values.
This renewed engagement is not without tension. Differences in interpretation can and do arise, particularly in areas where medical innovation moves more quickly than the ethical frameworks that guide it. Yet these moments can also strengthen relationships rather than strain them. They underscore the reality that Catholic healthcare is both ecclesial and professional, a ministry that requires ongoing dialogue between those who teach and those who practice. Hopefully, this renewed dialogue will strengthen the relationships between healthcare and Church leadership so that future challenges can be addressed together, rather than apart.
TOWARD A MORE RESPONSIVE ETHICAL FRAMEWORK
The third and most forward-looking impact of the seventh edition is the conversation it has sparked about the development of the ERDs themselves. Healthcare is changing at a pace that challenges traditional models of ethical guidance. Advances in biotechnology and artificial intelligence, the expansion of care delivery models, and the increasing complexity of nationwide health issues raise new questions. While the ERDs remain a foundational resource, their revision cycle and method can struggle to keep pace with these developments.
The seventh edition has brought this reality into sharper focus. By addressing several emerging issues, it demonstrates both the importance and the limitations of the current revision pro-
cess. Leaders across the ministry are now asking whether additional resources might be needed to provide more timely guidance.
Some have proposed developing supplemental resources, such as interpretive statements, casebased analyses or clinical educational modules, that can be issued more rapidly while remaining true to Church teaching. Others have emphasized the need for stronger networks of ethicists who can share insights and develop consistent approaches across systems.
What is emerging is not a call to replace the ERDs, but to extend their practical application. For leaders, this is not an abstract concern; it is a practical one. The ability of Catholic healthcare to respond faithfully to emerging challenges depends, in part, on the tools available.
AN INVITATION TO RECOMMIT
What, then, should we take from this moment?
First, the seventh edition should be understood as an opportunity for reengagement. Formation efforts should be reviewed to see whether they move beyond dissemination toward integration, helping staff at all levels to see their work through the lens of Catholic moral tradition.
Second, relationships with bishops should be reengaged and renewed.
Third, leaders should participate in emerging conversations about the future of ethics within the ministry. This includes supporting the development of new resources, fostering collaboration among ethicists, and contributing practical ideas to ecclesial discussions.
The seventh edition of the ERDs is the next step in a long tradition. The Church has always sought to help articulate moral principles that are both faithful and practical. For Catholic healthcare, the task is not simply to receive the revised directives, but to live them. It happens in clinical encounters, organizational discernment and ecclesial relationships. In that sense, the seventh edition is an invitation for leaders to recommit to the tradition’s moral truths and the mission of Catholic healthcare.
NATHANIEL BLANTON HIBNER, PhD, is senior director, ethics, for the Catholic Health Association, St.
Louis.
Navigating the complex ethical realities of healthcare can be a challenge.
WE’RE HERE TO HELP.
Access a variety of resources to help understand and apply the Ethical and Religious Directives.
FORMATION
HOW EXPERIENCE, CULTURE AND TRADITION SHAPE CATHOLIC HEALTHCARE: THE FORMATION TRIANGLE
Ministry formation weaves together the head and the heart. Through the years, it has developed its own distinctiveness. It differs from education, though drawing on knowledge and information. It also differs from formation in religious communities or parish and diocesan settings. A key distinctive feature is that our work transpires in a pluralistic environment, not exclusive to the community of believers.
M. HENSON
This is why CHA defines ministry formation as “discovering connections between personal meaning and organizational purpose,” or mission. Further, “these connections inspire and enable participants to articulate, integrate and implement the foundational elements of Catholic health ministry so that it flourishes now and into the future.”1
Creating the conditions for these connections is the art of formation. The leaders at the Ministry Leadership Center, an organization that developed leaders in Catholic healthcare, offered the Formation Triangle as a method for sparking such connections. This formation method integrates culture, personal and communal experience, and dialogue with the Catholic tradition.2 The model’s three points give mission and formation leaders the indispensable ingredients for any formation experience: lived experience, culture and tradition.
These three areas of the triangle are explored here in part because a recent survey of formation leaders in Catholic health ministries found that a significant percentage come from educational backgrounds and may find this model useful in their formation offerings and programs.3 Many mission and formation leaders are well-versed in presenting and communicating aspects of the Catholic tradition. Yet getting it to land in the hearts and minds of participants is the difficult and essential work of formation. The tradition must be engaged in dynamic dialogue with culture and individual and communal experience,
sparking connections that shape personal and organizational spirituality.
EXPERIENCE
Each person who walks into the room for a formation program brings their whole lived experience. Even more, each person is an expert, whether in information technology, medicine, revenue cycle, community health and so forth. Those leading the formation experience must recognize and honor the vast experience and expertise present in the individuals gathered. This may include experiences of parenting and partnership, as well as suffering, accomplishments, love and more. Adults learn by accessing their own repository of memory, learning, feeling and intuition — that is, their whole selves.
Communal experience also includes working and leading within this organization. The formative experience also enables real-time processing of the formation topic with participants and the larger group. For example, if a finance leader has never engaged with healthcare ethics, facilitation prompts them to discuss how they’re receiving the content in real time. As the table conversation unfolds, what are they hearing? Where do they see connections to their team and leadership?
In the formation triangle model, experience evaluates the content, the way it is presented and the way it is facilitated in the formation program. “The leaders use past experience to assess the material from the Catholic tradition and the cultural information and determine what they want their future experience to be.”4 From this bank of collected information and knowledge, leaders assess the content from the Catholic tradition, in
DARREN
Catholic Tradition
Sets the Agenda
Cultural Information
Informs the Agenda
Foundational Concerns
Individual & Communal Experience
Evaluates the Agenda
light of the cultural realities, to determine how they may integrate and apply the formation experience into their roles.
CULTURE
In the formation triangle, the culture informs the agenda. Culture, first and foremost, includes the organizational culture. It also includes society and the culture of healthcare, business, service, technology and the like. Cultural spheres provide a context for how individuals come into formation programs and experiences, which is why pioneers in Catholic healthcare ministry formation, Larry O’Connell and Jack Shea, say that it informs the agenda. This includes “pertinent data from the social sciences, cultural analyses, contemporary philosophies, and, most of all, current organizational protocols and processes.”5
The cultural context matters for how the tradition will be received or interpreted. Having worked at ministries in southern Kansas, where prayer with references to God or Jesus was
Formation Triangle used with permission from the Ministry Leadership Center
expected before meetings, and in other settings where overt religious references can draw skepticism, I tailor reflections to resonate with each audience. These cultural realities give guidance for leading a formation experience.
This corner of the formation triangle echoes the oft-cited line from Gaudium et Spes (“Joy and Hope”) that the Church in the modern world has a “duty of scrutinizing the signs of the times.”6
Formation programs provide the space and time for those leading the healing ministry to read and scrutinize current movements in culture and society, doing so individually and with the wisdom of a community of experts. Yet, the call of the Second Vatican Council, and now the Synod on Synodality7, is that we interrogate social currents from the Gospel, which is the tradition’s foundation.
TRADITION
The Catholic tradition sets, or rather, grounds the entire formation experience. Now, this does not mean that a formation facilitator starts with doc-
trinal pronouncements. As a theology professor of mine would say, you don’t convince a kid that baseball is fascinating to both play and watch by telling them about the infield fly rule!
I have found this especially true for business executives, including those from start-up, venture capital or highly specialized healthcare delivery fields. Few, if any, will be interested in ministry formation by starting with the intricacies of Catholic doctrine.
However, formation participants may be inspired by the story of a courageous woman who came to a new community during its early settlement and helped to found a ward for the town’s sick. In the formation triangle, the tradition includes a broad spectrum of themes related to Catholic identity: whether through heritage stories of the founding communities, the Scriptures, Catholic moral and theological tradition, the social teaching, the Ethical and Religious Directives for Catholic Health Care Services, or spiritual traditions, rituals and practices.8
The tradition sets the agenda for a formation experience. This means it is not only the main topic of the presented content, but also the arena in which participants read the signs of the times (culture) and interpret their lived experiences. “The Catholic tradition provides theological perspectives about why these concerns are important, ethical guidelines for addressing them, and insights into their implications.”9
O’Connell and Shea describe the corner labeled Catholic tradition as “shorthand for the process of theological reflection that serves as the living link between the past and present. It ensures that ‘the appeal to tradition is not mere remembrance of the past,’ but a call ‘to develop for the future an original, new and constructive mode of thinking.’”11
AGENTS OF A LIVING TRADITION
The formation triangle is an apt model for developing the working knowledge and skills needed to animate the formation framework. “The tradition identifies the areas of knowledge that make up the mission and ministry. But it immediately combines those areas with current cultural assumptions and information and, in the process, makes that knowledge ‘working’ and relevant to the organizational challenges of healthcare. As the tradition and culture come together into working knowledge, they consult the experience of the leaders. The leaders articulate how this working knowledge relates to their situations and how it can be integrated into the organizational life and mission. The three points of the triangle are in ongoing interaction with one another, contributing to the development of working knowledge and skills.”12
The formation triangle becomes a significant tool for connecting people to the mission and meaning of working in Catholic healthcare as a lived commitment. Participants “wake up to the fact that they are more than observers, and that formation is more than a pseudo-graduate class.”
Ministry formation facilitates ways to adapt knowledge and practices (elements of the tradition) into “the organizational categories of the working knowledge and skills that leaders must have to lead the mission and ministry of Catholic healthcare.”10
The formation triangle provides additional benefits. First, it supplies a unity to the different modules that comprise a formation program. The consistency provides participants with a solid and familiar pattern for addressing various topics, such as vocation, ethics, social tradition, ecclesial relations and so forth. Second, as leaders approach decision-making and discernment processes, the model once again provides familiar territory. Strategic decisions flowing directly from the mission incorporate the tradition, consider the culture, and honor the experience of stakeholders.13
The formation triangle becomes a significant tool for connecting people to the mission and meaning of working in Catholic healthcare as a lived commitment. Participants “wake up to the fact that they are more than observers, and that
formation is more than a pseudo-graduate class. They come to terms with the knowledge that the tradition is living and they are agents of it. They are the stewards of the heritage entrusted to them with the expectation that they have real responsibility for the Catholic identity of the organization.” As O’Connell observes, “They are not involved in a handoff; they are an integral part of a vital process, the instrument of a throbbing reality that ‘exists from out of the present now toward our future.’”14 Leaders begin to see that they are called to mediate the practical wisdom and spiritual values of a community of members and tradition.
The role of the mission or formation facilitator is to know the tradition and bring its elements into the present dialogue in service to the continuous development of both the individuals and the tradition itself. Formation is inherently theological in that it endeavors to “honor the tradition while both respecting and challenging culture in ways that resonate with the individual and communal experiences.”15
DARREN M. HENSON, PhD, STL, is senior director of ministry formation at the Catholic Health Association, St. Louis.
NOTES
1. “Framework for Ministry Formation,” Catholic Health Association, 2020, https://www.chausa.org/docs/ default-source/formation-resources/frameworkfor-ministry-formation_v11.pdf.
2. Laurence J. O’Connell and John Shea, eds., Tradition on the Move: Leadership Formation in Catholic Health Care
(MLC Press, 2013).
3. Per the formation leader survey, 40% had worked in either a Catholic parish or an educational setting, ranging from grade school through higher education. See the following: Darren M. Henson, “Findings from CHA Survey: Formation Reaches Deeper Into Ministries, Increases Demand for New Resources,” Health Progress 106, no. 4 (2025): https://www.chausa.org/news-andpublications/publications/health-progress/archives/ fall-2025/findings-from-cha-survey--formationreaches-deeper-into-ministries--increases-demandfor-new-resources.
4. O’Connell and Shea, Tradition on the Move, 80. 5. O’Connell and Shea, Tradition on the Move, 80.
6. Second Vatican Council, Gaudium et Spes, Preface, section 4, https://www.vatican.va/archive/ hist_councils/ii_vatican_council/documents/ vat-ii_const_19651207_gaudium-et-spes_en.html.
7. “For a Synodal Church: Communion, Participation, Mission,” The Synod, November 24, 2024, https:// www.synod.va/content/dam/synod/news/2024-10-26_ final-document/ENG---Documento-finale.pdf.
8. “Framework for Ministry Formation,” Catholic Health Association. CHA’s Framework for Ministry Formation enumerates six foundational elements of the broad Catholic tradition: vocation, tradition (which includes scripture, doctrine, etc.), spirituality, ethics, the Catholic social tradition and discernment. See pages 8-9.
9. O’Connell and Shea, Tradition on the Move, 80.
10. Tradition on the Move, 66.
11. Tradition on the Move, 98.
12. Tradition on the Move, 80.
13. Tradition on the Move, 80-81.
14. Tradition on the Move, 100.
15. Tradition on the Move, 99.
THINKING GLOBALLY
STRENGTHENING GLOBAL SOLIDARITY THROUGH DISCERNMENT, DIALOGUE AND DIRECTION
Catholic healthcare in the United States is inseparably linked to global health. As global interconnectedness grows, many might point to the importance of health security, resilient systems that protect against pandemics and other widespread health threats, at home and globally. CHA and other organizations have also conducted extensive analysis and education to explore the ethical implications of how the U.S. employs an increasing share of its health workforce from low- and middle-income countries to care for patients in ministry facilities.1
BRUCE
These realities demand honest reflection about our role in global health. If we fail to engage globally with intention and solidarity, today’s funding shifts will devastate the very health systems that educate and train much of our workforce.2 More than anything, this moment reveals a simple truth we can no longer ignore: Global health is local health.
As we navigate rapid shifts in U.S. global health policy, widening geopolitical instability, and an increasing need for access to care worldwide, we are called to a renewed commitment to our Gospel mission and our role as part of the Church.
Discernment:
Remembering Why We Are Called to This Work
CHA members and the broader faith-based community understand the importance of service, especially to those who are most in need. This is not an optional dimension of our identity — it is at the heart of who we are and the legacy of the Catholic health ministry’s founding congregations.
Catholic healthcare in the U.S. exists today because missionaries from Europe and beyond came to these shores in the 18th, 19th and early 20th cen-
turies. Their global outreach, rooted in courage, faith and solidarity, gave birth to our hospitals, schools and social services. While they, like us, were not perfect, Catholic ministries stand on the shoulders of those women and men who crossed oceans, often at great risk. A series of gatherings in Rome this spring reinforced my commitment to ensuring we continue the tradition of global solidarity that those priests, sisters and brothers lived through their actions.
The Pontifical Academy for Life’s conference “Healthcare for All: Sustainability and Equity,” the Dicastery for Promoting Integral Human Development’s “Committed to Water, Sanitation and Hygiene (WASH) in Healthcare Facilities” convening, and additional conversations at the Dicastery brought the realities of a divided and hurting world into sharper focus. These discussions also served as a reminder that the global community continues to rely on Catholic healthcare as a consistent and reliable partner, even when conventional service providers and systems fail.
Dialogue:
How Shared Understanding Strengthens Our Mission
Through decades of dialogue, shared learning and collaboration, CHA members have refined programs, expanded reach, improved efficiency and deepened impact across the country.
COMPTON
Yet the changing dynamics with religious congregations, particularly the decline in vocations, have altered the landscape of the Church’s global outreach. Geopolitical shifts — including cuts to aid, changing priorities and ongoing wars — threaten to reverse long- and short-term global health gains. Many international health systems are facing critical shortages of personnel, supplies and lifesaving equipment. The shortages are especially acute in rural areas, where faith-based and Catholic facilities are often the only option for communities and where our brothers and sisters are among the poorest and most vulnerable. These realities were underscored during the Dicastery’s WASH convening in Rome, where Catholic, ecumenical, interfaith and secular partners gathered. The conversations revealed both the scale of unmet need and the depth of existing Catholic leadership already engaged in strengthening health systems through foundational interventions such as WASH. For example, while improvements have been made to 87 of the 150 facilities in the Dicastery’s WASH initiative, the remaining 63 still require support.
What emerged from the discussions was that no single system, congregation or organization can meet these challenges alone. Progress depends on intentional dialogue, shared learning and coordination across Catholic health systems, global implementers, researchers and Church partners. These challenges demand renewed dialogue within the U.S., as global and domestic organizations discern how best to respond.
Direction:
Building Resilient Health Systems
The Church’s messages at the Pontifical Academy for Life and WASH in healthcare facilities gatherings were aligned and clear: Healthcare cannot be a privilege. It is a moral imperative.
If we are to meet this moment faithfully, Catholic healthcare must recognize that global health is deeply connected to local health. The clinicians and technicians trained abroad, who now fill workforce shortages in U.S. hospitals, represent an investment that low- and middle-income countries have made in us. That investment must be valued and considered appropriately as part of global health, which is truly a two-way street. What is needed today is a paradigm shift that will lead us to a global health strategy rooted in sustainability and accountability: Scale up today so communities can scale
down dependence tomorrow.
Shift from an aid mentality to a mutually beneficial partnership mentality.
Strengthen local capacity, leadership and self-reliance.
Encourage system change, not individual projects.
The Rome discussions also highlighted that sustainable global health engagements require stronger alignment between operational experience and evidence generation. Partners repeatedly emphasized the need for more structured opportunities to document what works, identify where gaps persist, and collectively accelerate progress. Areas such as WASH in healthcare facilities, supply chain resilience and the mobility of the global health workforce offer opportunities not only for implementation but also for shared research, learning and advocacy, thereby strengthening both local impact and global influence.
What Doing More Looks Like
At times like these, shared discernment and dialogue are not luxuries. They are necessary tools for strategic action. It is from such shared discernment that sustainable strategies can take root:
1. Think beyond individual systems:
To achieve an impact greater than the sum of our parts, global Catholic health ministries must pursue strategic alliances that allow for shared problem-solving, collaborative investment in workforce development, and coordinated action.
2. Reimagine care through partnership: By working collaboratively across CHA systems and in partnership with the local Church, communities and governments, we can reimagine how health services are delivered and sustained.
3. Prioritize catalytic interventions: Efforts such as rebuilding the global health workforce, building resilient supply chains for medical equipment and essential supplies, or securing WASH for health facilities can trigger systemwide strengthening.
Experiences shared in Rome demonstrated how collaboration across Catholic systems and global partners can reduce duplication and increase impact. Through joint investment in
WASH infrastructure, coordinated technical assistance, or shared engagement with the Vatican and multilateral partners, collective action allows ministries to leverage scale while remaining rooted in local accompaniment.
At the WASH meeting, CHA’s President and CEO Sr. Mary Haddad, RSM, noted that CHA’s role as a trusted convener positions it to help members explore collaborative models to be United for Change in healthcare, part of the organization’s strategic plan. Collaboration can identify strategic entry points and allow for discernment where shared action can lead to systemwide strengthening rather than isolated gains. These interventions are not only possible but also urgently needed.
A Shared Path Forward
The recent conversations, coupled with the feedback we continue to receive through our U.S. global health policy reflections and survey, reaffirm that Catholic healthcare has both the opportunity and the responsibility to lead boldly.
CHA looks forward to engaging with Catholic healthcare and partners as we forge a path to im-
prove health and well-being for all.
Your perspective is essential as we discern the future of Catholic global health engagement. We invite you into deeper dialogue as we seek to learn about opportunities, barriers, hopes and the commitments required for genuine transformation.
Let’s continue this work together and schedule a conversation to explore your role, your system’s role and how we might do more — together and for the right reasons. Contact Bruce Compton at bcompton@chausa.org.
BRUCE COMPTON is senior director, global health, for the Catholic Health Association, St. Louis.
NOTES
1. “The Future of Health Workforce–2025 Edition,” Catholic Health Association, https://www.chausa. org/focus-areas/global-health/resources/resource/ future-of-health-workforce.
2. Vibhu Mishra, “Global Health Systems ‘At Risk’ as Funding Cuts Bite, Warns WHO,” United Nations, February 2, 2026, https://news.un.org/en/ story/2026/02/1166869.
CHA Global Health Resources
RECENT UPDATES • THE FUTURE OF HEALTH WORKFORCE DISCUSSION PAPER NEW • GLOBAL WORKFORCE ETHICS & STRATEGY CHECKLIST
Scan the QR code to access the PDF or download it at: chausa.org/ globalhealth
Before we speak of systems or technologies, we are invited to pause.
Recall the moment you leave an encounter with healthcare — a hospital, a clinic, a doctor’s office or a quiet exam room. You step back into ordinary life carrying more than instructions or results:
a body still tender, a mind replaying what was said, a heart holding relief, fear or unanswered questions.
This is where healthcare continues — at the kitchen table, in the car ride home, in conversations with loved ones, in the quiet moments when meaning begins to settle.
What people carry from these encounters matters. Healthcare does not end when the visit ends. It continues as patients return home — to families, communities and the quiet spaces where fear, hope and meaning are held together. What we offer in moments of care extends beyond our walls. The question is not only what technologies we deploy or how efficiently we work, but how our encounters leave patients: more whole or more fragmented, more human or more alone.
In a time of remarkable technological advancement, we are reminded that healing is never merely technical. It is relational. No technology, however sophisticated, can replace the sacred work of witnessing another’s
vulnerability or accompanying them through uncertainty.
And yet, we labor within systems under immense pressure, called to do more, do it faster, and sometimes with fewer resources. Too often, we are made to feel that what we offer is not enough. In such an environment, technology can either deepen that wound or help restore balance by freeing time for relationships, reducing burdens and allowing care to return to its proper purpose.
At its heart, healthcare exists for human flourishing. Rooted in the conviction that every person bears inherent dignity, our ministry accompanies people in moments of vulnerability, entering the uncertainty and complexity of their lives with compassion, rather than shrinking from that uncertainty or seeking to control it. Catholic healthcare does not pursue efficiency at the expense of encounter. It seeks presence that heals, wisdom that guides innovation, and care that remains faithful to love.
As we discern the place of AI and emerging technologies in healthcare, the question before us is not simply what is possible, but what is faithful to the dignity of the human person and the mission entrusted to us.
REFLECT
Please consider these questions: In my own role within Catholic healthcare, where do efficiency, technology and urgency support human flourishing? Where might they quietly diminish encounter, attention or dignity?
What does it mean to practice
“Prayer Service,”
healthcare as an act of accompaniment — staying present to vulnerability, uncertainty and complexity — so that innovation remains in service of love rather than replacing it?
PAUSE AND PRAY
God of accompaniment: When care is complete and doors close behind us, what do Your people carry home from our hands?
As we shape the future of healthcare, slow our striving and widen our vision.
Teach us to use every tool in service of healing without surrendering the human heart of our work.
When efficiency tempts us to hurry past suffering, draw us back into presence. When pressure tells us we are not enough, remind us that love faithfully given is never wasted.
Bless all who create, govern and use new technologies, that innovation may serve relationship, and progress may deepen compassion.
Shape our questions, not around what is possible, but around what is worthy of the human person made in Your image. Amen.
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Considered an essential primer for new and current leaders in Catholic healthcare, Foundations of Catholic Healthcare Leadership deepens understanding of the pivotal role leaders play in carrying out the healing mission of Catholic healthcare in serving the needs of patients, families, communities and the common good.