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April.
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upper right. We're looking forward to hosting you
in Chicago.
This is Laura Dirda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
doctor Zafar Chowdhury, senior vice president and chief
digital officer as well as chief AI and
information officer at Seattle Children's.
Doctor Chowdhury, thank you so much for being
here today. Thanks for having me. My pleasure.
Absolutely. Well, I know we're gonna talk a
lot about technology and AI and how you're
looking at the future. But before we dive
into that, can you tell us a little
bit more about yourself and Seattle Children's?
Yeah. So
I've been running the IT shop here at
Seattle Children's. It's been about eight and a
half years,
but I've been in the health care IT
industry.
This is year 40, and I actually started
my journey
in health,
as a physician. So I'm
one of those folks that has defected to
the dark side over many years and now
fully embedded
on the technology side.
Absolutely. That's, fantastic to hear. And, you know,
I know you've got a lot going on,
especially when it comes to AI and and
some really advanced things that you're doing there
at Seattle Children's. And so I'm excited to
dig in. Can you tell us a little
bit more about some of the things you've
been doing in the last year? What's an
initiative you're most proud of? What did you
do, and what were the results?
Yeah. So I think, you know, AI,
obviously,
2026,
huge buzz around AI. We've been doing AI
for quite a few years now, and it
just
seems to get better with the more data
you feed into the engine.
So about eighteen months ago, we started a
refresh of
our data warehouse. So the question was,
how do you get the right information into
the right place? Because that's the information you're
going to need
to build your AI models
so that they're accurate and are beneficial to
an organization.
So we moved from an older platform, which
was IBM Netezza on prem
to a full Google Cloud platform
for all of our data analytics.
And
our data lake is fed with a 171
systems
at present, and that's where all of our
data resides. And then from that data,
we've been working with stakeholders. So I truly
believe that the use cases for AI are
focused
on what do the end users need, not
necessarily what I think they need. And so
one of our most successful programs, we use
that Google platform. We use Gemini
AI. We use Vertex AI.
So, of course, we did
the training mandatory for everyone in AI in
our organization.
We set up a AI
user policy.
We have an AI review board that reviews
all the intake
for use cases that
our stakeholders are asking for.
And then out of that, what came
about was our first agentic AI model, which
we call Pathway Assistant. And what we did
is we took
many, many, many years' worth of knowledge
around clinical pathways
to treat
kids
that we had developed.
And we actually
freely give those pathways away to hospitals that
want to use them around the world.
And we took those pathways,
six, seven thousand pages of PDFs
validated by clinicians over the years,
and we fed it into an agent, which
we call Pathway Assistant.
And that agent was able to amalgamate that
information
and then create an AgenTiKa
agent that allows people
to query it and question it and have
a dialogue with it. So if you're a
a new physician and you're trying to learn
how to practice medicine in pediatrics,
you can tell the agent
about your patient, the age, the weight, the
symptoms,
what's going on with the patient. And the
agent will look at all the information it
has access to and start guiding that physician
through the care pathway
for that patient. It will tell
the physician
what to do next, what tests to run,
ask for the results of the test, then
step through the diagnosis, the differential,
the treatment plan.
That helps
newly trained physicians learn how to practice.
For
seasoned physicians,
it's a validation
tool. It makes sure that they
are doing the right thing for the right
diagnosis, the right condition. And that's been very,
very accurate
and very, very successful.
And that that that then becomes your friend,
you know, that phone a friend thing, and
you're able to query it and get the
answers that you need. So that's one example
of an agentic AI that we built. Another
example,
is a translation
assistant.
So we have a patient population that is
varied.
We tested
English to Spanish translation
of instructions,
discharge instructions, etcetera, post op instructions.
That's been hugely successful.
We did find, though, that
AI agents translating to other languages
like Ukrainian
and Somali word as accurate, and so we
didn't pursue
other languages. So we're doing English to Spanish
and Spanish to English.
That's another example,
of a use case that has been valuable
not only to our clinical staff but also
to our patient population. So those are some
of the things we've been working on. There's
many more. Of course, there's more in the
pipeline
than we can probably afford to do or
our resource to do in one year, but
we're stepping through multiple
use cases. The third one I'll throw out
there is Ambient AI.
We've agreed we've
set up a partnership with the bridge, and
we have launched the Ambient AI transcription
for all of our physicians. We bought an
enterprise license, and that's currently being rolled out
with huge success,
great feedback from our clinicians in the test
phase.
Many tell us that they would never allow
us to take this tool away from them.
So that's another win that we've had in
the AI space.
That's amazing to hear. And I think especially
really cool to understand how you're using AI,
looking at AI agents,
looking at some of the diagnoses and validations,
as well as then getting into, the the,
translation as well. And, of course, you know,
ambient technology is something that has become so
much more prevalent, especially in the last twelve
months, within many organizations. And echoing those same
sentiments that clinicians are are finding it,
extremely beneficial in in time savings and and,
also for their relationships with patients and satisfaction
with their jobs overall. So I think that's
amazing to hear. And, you know,
my thing I'm curious about is for any
one of these use cases, whether it's Ambient
or some of the agents and more, how
do you make sure that they are continuing
to work at the level that they're supposed
to? How do you measure that success and
then, continue monitoring them, to make sure that
there aren't unwanted changes as time goes on.
So the success with these use cases has
to come from the partnership
between IT
and the clinical teams. So
we may be the folks that engineer the
back end of these tools and these agents,
but on the front end, there are many
doctors involved. So for our pathway assistant,
we had 50 physicians work on this project,
each of which dedicated about one hundred hours
of their time.
So that was in the build, design,
test,
post test phase.
And the same group of physicians
predominantly in my informatics team
are always
testing and checking. If new pathways are added,
those pathways are validated,
tested, torture tested, and then released into the
agent. So it's a it's a continuous PDSA
cycle.
But you don't do that with IT people.
You do that with the people that use
the tool on a day in, day out
basis.
And the people
are volunteering their time because they see the
value of the tool for them in their
day to day work. And so that's the
partnership you really have to build.
Because if it's only driven by IT because
it's the next shiny toy, you're not going
to get
adoption and you're certainly not going to get
the most important thing in AI, which is
sustainability
of solutions.
Because it's easy to create something shiny and
then people
won't use it after a few weeks. It's
hard to get them to continually use it,
provide feedback.
If there's technical tweaks, the team can do
any technical tweaks, but it is a PDSA
cycle.
Got it. That makes a lot of sense.
And, you know, it is really helpful context
for how these different,
teams and departments work together in order to
make sure that the technology is functioning in
a the most beneficial way possible.
Now looking ahead into 2026, what are some
of the big priorities and headwinds that you're
most focused on?
So in 2026,
of course, we've got to make sure that
the costs
that we have
in providing
the support services and IT
are optimized and continue to remain optimized.
We're going to continue to do some application
rationalization
because
we have a lot of different systems, and
we need to validate whether those systems are
still off use in 2026.
We have consolidated
and outsourced
most recently all of our infrastructure.
So all of our servers, storage,
backup,
disaster recovery
for all of our systems is now a
service contract
that we don't run that's outsourced to Rackspace.
And that's been very successful because that helps
us deal with our technology
debt
in the future and also allows us to
have service level based,
infrastructure, which is important if you're trying to
grow in the AI space because the demands
on infrastructure won't go down. They will continue
to go up.
And at the same time, I like to,
almost every year, take a look at my
organizational structure in IT
and make sure that that is still optimized
and fits the needs
of the customers I serve, which are the
end users,
the clinicians, the patients, the parents, caregivers.
We'll also continue to build tools,
in our patient facing app.
We have a patient and parent advisory group.
We meet with them monthly,
and they tell us the things that we
should build, that they need, that to help
them navigate our health system. So we'll continue
to innovate
in the digital space
at the front end and that will also
continue this year. And the other thing we'll
do is we'll continue to track any regulatory
changes,
federal changes that impact us.
The thing that will always keep us up
at night moving through 2026
will be cybersecurity.
So, we will continue to keep
our eye on that
and also
continue to optimize tools in that space. There
is also use of AI
around cybersecurity
to protect our organization,
and we'll continue to
educate and train our end users in the
cybersecurity
risks and pitfalls
that are very easy to fall into.
That's helpful to understand. You know, I I
know so many different areas that,
you touched on are are so critical, but,
it it was cool to hear you talking
about some of the different,
things that you're doing in order to meet
the needs of of patients,
especially,
you know, with some of the the feedback
you're getting in the advisory group.
Is there anything you've been able to build
because of their feedback that, you know, has
been particularly successful? Any success stories you can
share with us? Yeah. So I think one
of the really interesting ones was
around surgical notification. So the the use case
was that when,
a patient goes into surgery,
the parent usually
accompanies their child
and then waits for their child whilst the
child is in surgery. And as you know,
there are different types of surgeries. Some are
short, some are extremely long. But when you
are a worried patient,
you don't necessarily know if you should leave
the surgical suite because you don't know when
your child is coming out of surgery
or if there are any updates about your
child in surgery.
So the feedback we had from our patients
was the parents of our patients was that
I can't leave the Surgical Suite and sometimes
my kid's in surgery for four, five, six,
seven hours
and I'm afraid to leave
because something might happen and I wouldn't know
because they wouldn't be able to find me.
And what that means for me is I
don't even have the opportunity to go and
get a coffee or even get something to
eat.
So could you build us something
that could keep us informed and then allow
us to not be stuck in one place?
Within our digital front door app, we added
a component
that actually
keeps that parent or caregiver
updated
on where their child is in in what
stage in the surgical suite.
And, it's code based. So we issue them
a code. They can see on their app
or even on the the big board in
surgery, and it will tell them whether the
child has been
taken in,
is in intake, is in surgery,
is in post op, is in recovery,
where they are exactly,
which then frees the parent or caregiver
to go out and, yeah, get that small
sandwich to eat so that they can continue
to
not be anxious,
and then come back in time to
welcome their child back from surgery. So that's
a really small thing,
but it's a big thing to someone who
is
super worried about their child and doesn't wanna
move from one location.
Absolutely. That's such a powerful example of the
ways that, you know, technology,
can provide
a big difference within the the care journey
and, you know, truly, truly,
amazing, I can imagine, for the families to
be able to have, you know, that peace
of mind when a child is going through
surgery, which is huge.
Now I'm curious. What do you think the
hardest thing you'll have to do in the
coming year will be?
I think the hardest thing for us in
'26
will be
deciphering the impact on our health system around
the big bill
that was approved.
And then for me in IT, trying to
figure out what that means financially to my
budget.
Because I have to right size my budget,
balance my books, and still continue to provide
the services
that our stakeholders and our patients and our
parents need.
And that's not always easy in a climate
when
costs are actually going up. You know, as
you know,
we've been talking about AI today, but those
tools cost money.
Infrastructure
costs money.
Labor and skill sets cost money, and those
costs aren't coming down. So
this year, we'll have to be very, very
careful around
continuing to innovate, but also continuing
to do more for less and be fiscally
responsible because we need to do that so
that we can keep our lights on and
doors open.
That's such a good point. And I think
especially when you look at some of the
financial pressures, I know every dollar in health
care is precious and,
investing in technology, while critical, especially when you're
trying to make sure you've got the right
experience
in quality and efficiencies,
you know, certainly requires an amount of,
value that it has to bring back into
the system. And so when you're making these
decisions,
and having that fiscal responsibility
in mind,
what do you see as being rising to
the top, I guess, for your,
the next year? And and how do you
work with different companies and vendors in your
team as well, to make sure that they're
making the right decisions,
given those limited resources?
Yeah. So I think the most important thing
for any health IT shop is to validate
everything that they are actually running on a
daily basis. You know, we have,
over a thousand different applications that we support
and run at Seattle Children's. And the question
I always ask my team
is, are we sure those are the right
tools
and there are the right software applications that
we should continue to use?
And that's not a question we answer. We
have to go and ask the stakeholders who
use those tools.
If there are tools that really aren't being
used or can be archived, can be deprecated,
can be consolidated
into newer tools that we've purchased,
then we need to undertake that exercise.
Rationalization
year on year is always key, and you
do that rationalization
in partnership
with the actual users
of those systems.
Also in parallel,
we're going to have many, many
tools and subscriptions
come up this year as we do every
year. And we will we have a vendor
management team,
in IT. We work with our supply chain,
and we always
fight back. So when a renewal comes through,
we look at the renewal. We see how
much it has gone up. We then go
back and forth and fight the good fight
to make sure that
the increase isn't too taxing
on our budget budgetary model. And so that's
I would say sometimes that's the fun part
of going back and forth and arguing till
you get to something that's amicable
for both sides because
vendor relationships are partnerships.
So we do that consistently, and I have
a team that pushes back on renewals and
make sure that we're renewing at the right
rate so that we can actually afford it.
And then
going through the health system and making sure
that we've inventoried all of our assets,
Asset management can sometimes be a problem.
Make sure that we have,
taken in all the equipment that needs to
be replaced and making sure that
any equipment that's end of life is either
deprecated or replaced.
And if you continually do that, then that
you'll find tools,
pieces of hardware
that you don't need. And if you can
decommission those pieces of hardware, that also ends
up saving money because you don't renew
on maintenance and support.
So then you have to do a good
job around your IT asset management portfolio.
Otherwise, you'll have
massive amounts of hardware sprawl that becomes unmanageable.
So the team will also spend the year
going through all of those lists and making
sure that,
firstly, we can find everything, and secondly,
making sure everything should stay in place or
be deprecated.
That's helpful to understand. Thank you for laying
out that process so clearly, and I think
it goes back to something else you mentioned
at the beginning of our conversation looking at,
you know, decommissioning those things that aren't in
use anymore in in managing that technical debt
in a different way.
So, especially, when you think about that technical
debt, I mean, how does your team approach,
those conversations or really efficiently
managing some of those things and so you
can cut back on on what, isn't in
use?
Yeah. So I think the interesting thing about
working in health and health IT is
a lot of the work that we do
isn't technical. It's very much communication.
So once you've
identified
assets,
the next step is to go and validate
the asset with the person
who has the asset or who we think
has the asset
and then validate whether that use case that
they have the asset for is still a
valid use case or not. Now we can
take the example of laptops.
How many times do you find out that
the user
has been issued more than one laptop in
your organization?
And then if they have, go and validate
whether they truly have two or three
or whether or not two of them are
no longer functioning and they never gave it
back to us for decommissioning.
So it's it's it's sort of
a detective work
in addition to lots of communication.
And my job is to communicate to the
health system
about all these different initiatives that we have
and ask
my user community for help because we can't
do it alone. So sometimes we have amnesty
programs. Hey. If you have any of our
equipment that you didn't give back, let us
know. And people come forward and say, yeah.
I forgot to tell you this wasn't working.
I'll hand it back, and then we can
decommission it. So
my job is to communicate at system level
the different initiatives we have. Then the team
on the ground will go and interact
round in our different facilities,
look at things, find things,
either refresh things or
deprecate them altogether. And that's a that's a
continuous
cycle that we will undertake
during the year. Because the more you can
communicate
your challenges to your end users, the more
helpful they can actually be in
partnering with you to
to deal with the challenges ahead.
I love that. Thank you again for digging
a bit deeper there. Now before we wrap
up, I wanted to ask you about growth.
Where do you see some of the best
opportunities for organizational growth in the next couple
of years?
Well, certainly for us in pediatrics,
we are seeing growth,
in terms of patient demand
for our services.
So we will definitely be expanding
across the region
that we serve in terms of
access to clinics,
access to out of hours services
that our
parents and kids need,
and, you know,
more streamlined ways in getting
the appointments
and set secondary and tertiary care
that parents need
for their kiddos in the Pacific Northwest. So
it's a multipronged approach.
Some growth, some new clinics, some new ambulatory
centers,
and we will continue to do that through
'26
so that we can meet the growing capacity
that we have here in the Pacific Northwest.
I love that. Thank you so much, doctor
Chowdhury, for everything that, you have talked through
with us today. This has been such a
fascinating and valuable conversation. And, you know, I'm
excited to see you as well at our
annual meeting. I know you'll be,
there speaking on a panel and just, you
know, always excited to have you as part
of what we're doing here at Becker. So
thank you. Well, thank you. Thank you for
spending some time with me. Always a pleasure
pleasure to chat with you, Laura.