From Chart Review to Clinical Capacity Duke's AI Strategy

How Duke Is Building AI That Actually Works in Healthcare | Matt Cox, Duke Health Healthcare does not need more AI hype. It needs AI that can survive clinical reality: compliance, governance, patient safety, workflow, physician adoption, and the brutal operational pressure every health system is facing. In this episode of Boombostic Health, Bradley Bostic sits down live at ViVE 2026 with Matt Cox, Executive Director for Digital Value Creation at Duke Health, to unpack how Duke is moving from AI experimentation to real-world clinical impact. Matt shares how Duke is building its own AI capabilities, including the Scout LLM platform, to safely support use cases across the health system — from clinical research and chart review to virtual nursing, ambient documentation, operational efficiency, and clinician burnout. The standout example: Duke used Scout to review 200 pancreatic cancer patient charts in less than two hours — work that would typically take a PA or nurse practitioner one to two weeks. That is not theoretical AI. That is capacity creation. That is clinicians working at the top of their license. That is the future healthcare actually needs. In this episode Bradley and Matt discuss: Why Duke chose to build internal AI infrastructure instead of relying only on outside tools How Duke evaluates AI through governance, compliance, safety, bias, and clinical decision support The role of Duke Institute for Health Innovation and EHRX in exposing health data safely How Scout is helping accelerate chart review, clinical research, and protocol compliance Why AI's biggest opportunity may be giving time back to clinicians Duke's approach to investing in startups that solve real internal health system problems The growing importance of virtual nursing, ambient AI, and operating-room intelligence Why human factors may determine whether healthcare AI succeeds or fails What Matt is watching across the healthcare innovation landscape after ViVE Key Takeaways 1. The winning health systems will not just buy AI. They will govern it. Duke is not treating AI as a shiny object. It is building processes to test whether tools are safe, compliant, clinically appropriate, and operationally useful before scaling them. 2. AI only matters if it removes real friction. The Scout example shows the real promise: not replacing clinicians, but removing time-consuming administrative and review work so highly trained people can focus on patients, research, and care delivery. 3. Innovation starts with the problem, not the pitch deck. Duke's venture approach begins with internal pain points — nurse burnout, clinician burnout, access, capacity, and workflow — then looks for companies that can help solve them. Chapters 00:00 — Live from ViVE 2026 with Matt Cox of Duke Health 01:22 — Matt's role leading digital value creation at Duke 04:05 — How Duke built the foundation for healthcare AI through EHRX 05:04 — Why Duke created its own LLM capability 05:52 — Governing AI through safety, compliance, and clinical decision support 07:21 — Inside Scout, Duke's AI platform 08:18 — Reviewing 200 pancreatic cancer charts in under two hours 10:11 — Using AI to free clinicians and expand capacity 11:52 — Duke's shift from reactive innovation to targeted venture investing 12:44 — Why nurse burnout and virtual nursing are top priorities 14:07 — Ambient AI and the fastest adoption Matt has seen in healthcare 15:44 — How Duke prioritizes investment and implementation opportunities 17:42 — What Matt is learning at ViVE: human factors, new roles, and the future of work Featured Guest Matt Cox Executive Director, Digital Value Creation Duke Health Mentioned in this episode Duke Health Duke Institute for Health Innovation EHRX Scout LLM Platform Ambient AI Virtual Nursing Algorithm-Based Clinical Decision Support ViVE 2026 About Boombostic Health Boombostic Health puts a spotlight on the people, technologies, and ideas moving healthcare forward. Hosted by Bradley Bostic, each conversation explores the practical innovations reshaping care delivery, diagnostics, data, AI, and the future of healthcare. Subscribe for more conversations with the leaders building what comes next in healthcare.