EP46 - AMDIS Roundtable - Restoring Clinical Cognition in the AI-Ready EHR

In this AMDIS Roundtable, Dr. Eve Cunningham (Cadence), Dr. Howard Landa (Adventist Health), and Dr. Deepti Pandita (UCI Health) explore what it really means to build an AI-ready EHR. Moving beyond features and vendor roadmaps, they examine how data governance, workflow design, and clinical validation shape the physician's day — from inbox overload to exam-room disconnect. Together, they discuss shadow AI, cognitive burden, and the hard tradeoffs between optimizing legacy workflows and redesigning care. Their message is clear: the next generation EHR isn't about adding more technology — it's about restoring clinical cognition and rebuilding trust in how care gets delivered. Key Takeaways Bad data leads to bad AI — governance must come first. AI is math, not magic — noisy and inconsistent data amplify risk. Clinical validation is as important as data hygiene for meaningful AI use. The EHR disrupts connection when clinicians must focus on screens instead of patients. Ambient documentation restores presence but does not yet create a true intelligent clinical partner. Most AI tools solve isolated tasks, not the full end-to-end care workflow. Health systems need internal prompt and AI literacy — clinicians are not trained engineers. Third-party innovation fills gaps, but long contracts slow adaptation. Shadow AI often signals unmet needs, not noncompliance. Governance should enable safe experimentation rather than block innovation. Clinicians remain accountable for AI-driven decisions under current regulations. Patients are rapidly adopting AI tools, often without reliable guardrails. AI's highest near-term value is reducing cognitive and administrative burden. True progress requires redesigning workflows, not endlessly optimizing legacy processes. Leadership prioritization, not technology limits, often slows transformation. The next generation EHR must restore clinical cognition and trust. Episode Highlights 00:00 | The Key to a Successful EHR: Restoring Clinical Cognition 02:36 | When the EHR Slows Care Instead of Supporting It 01:08 | Why This Isn't About Features or Vendor Roadmaps 02:36 | When the EHR Slows Care Instead of Supporting It 03:46 | AI Is Math, Not Magic 04:05 | Data Governance as the Prerequisite for AI 05:23 | Governance + Clinical Validation = Actionable Intelligence 06:44 | The Keyboard Breaks the Sacred Patient Encounter 08:25 | Ambient Tools and the Return of Joy in Medicine 09:19 | The "Intelligence-Ready" EHR Vision 11:10 | Why Clinicians Aren't Prompt Engineers 12:39 | Is Epic Cosmos Ready for Prime Time? 14:01 | Contextual, Specialty-Specific Views at the Point of Care 15:08 | Third-Party Innovation vs EHR Vendor Lag 16:49 | When to Replace vs Layer New AI Tools 18:09 | Shadow AI as a Signal of Unmet Need 19:08 | Enabling Safe Experimentation Through Governance 20:55 | If AI Makes a Mistake, Who Is Liable? 23:35 | Where AI Should Help First: The Patient Journey 25:19 | Patients Are Already Using AI for Medical Advice 27:33 | Cognitive Scaffolding: Removing Clinical Noise 28:31 | Intelligent Synthesis vs Data Mining 29:13 | The Peer Challenge: How Do We Move 2–3x Faster? 30:02 | Leadership Indecision Slows Transformation 30:47 | Stop Optimizing Legacy Workflows 31:46 | Final Message: Technology Isn't the Barrier Anymore   Guests: Dr. Eve Cunningham, Dr. Howard Landa, Dr. Deepti Pandita Host: Gregg Malkary - Lighthouse Healthtech Cohost: Keith Washington - Companions in Courage Foundation Sponsored by: Simplifi Medical & Storage Systems Unlimited Audio/Video: Tim Jones - Health Nuts Media Marketing: Josh Troop - Troop-Creative Learn More at: www.beyond-blueprint.com