The Dark Side of the $50B AI Medical Boom

Lorraine Fernandes: Jobs are gonna be replaced by AI. It's growing in healthcare. Two times faster in healthcare than any other industry. It comes down to one single word. Trust. The focus on the future 2026. So we're gonna start the series on April 15th with digital health. Then we're gonna move to AI and healthcare. And yours truly, Chris, is gonna be the lead speaker for our April 29th event. Then we're gonna move to coding and classification and terminologies on May 13th. And then we're gonna close it out on May 27th talking about leadership and workforce development. Go to ifhima.org and you'll on our homepage you can sign up and decide what ticket might work best for you.

Chris Hutchins: Lorraine, it has been a while, and it's so good to see you. I'm really excited to welcome you to the Signal Room podcast.

Lorraine Fernandes: Well, thanks, Chris. It certainly has been a while.

Chris Hutchins: Ryan, I I don't I don't even remember. It's been a long time. And in very recently we reconnected again, and it's you know, the things that we thought were a big deal way back then turns out were insignificant compared to what we're dealing with today. So really excited to to hear from you what your experiences are, and of course you've been playing a really important role in IFHIMA and you know led it through uh some incredible years and now it's transitioning again. We're at a wonderful time of the year. There's some events coming up we'll get to talk about today, but I am thrilled to have you. So again, welcome to the signal room.

Lorraine Fernandes: Well, thank you much, Chris. I appreciate the invite.

Chris Hutchins: So let's just jump in. Um kind of alluded to the things that are much different than they do they were not so long ago. Let's talk about the role of health information management and then how has it really changed over the last decade? I mean, there's I'm sure there's tons, but um, there's probably some significant things that you can you can hit that probably will jar people's memory that maybe they've forgotten about.

Lorraine Fernandes: Well, and that's certainly true. And as I was thinking about what I would share with you and and your listeners, I'll probably reflect a little bit more than a decade since I have a 50-year career. I can't believe it.

Chris Hutchins: Uh and I've you started at 10 years old, just like me. I did. I did.

Lorraine Fernandes: I started at 10. And I'll reflect. Some of my thoughts are on my 12 years on the IFHIMA board, also. So I'll share a little insight, and and I'm sure this is going to spark further conversation. So in my career, I always had a passion for data, but honestly, I don't think I'm unique in that regard. I managed people in the quote-unquote traditional health information management department. I also managed uh almost from day one in my career, you know, the cancer registry or tumor registry as it was called, trauma registries and other types of clinical registries, because I just love data and any how to capture it, how to make sure it was accurate. And my staff, I I was lucky the first 10 years of my career. I found staff who shared my passion. Right. So you fast forward a bit and you say, okay, so we've evolved from paper early in my career to electronic for many reasons. And obviously, we know the US government did a significant investment in that from like, what was it, 2008 to 12, something like that. So paper in the US is largely gone, except for perhaps some specialty areas of healthcare, maybe some specialty clinics or other niches. But, you know, we still have shadow records in electronics, just like we did in paper. But the transition over the last 15 years, I believe, has created tremendous opportunity for health information or health information management professionals, because as a result of the infusion in the US from the federal government to move to electronic or to digital, HIM professionals had a chance to lead design and implementation teams, maybe for the products that were implemented in their respective departments. And from that go even bigger to leading larger teams who are more generic to functions, I'd say, in the healthcare system. And I think that was a fabulous springboard for the profession to go bigger, to go better, to go broader, whatever else you want to add there. And I think that created the environment where health information professionals, instead of just creating the data as we did from release of information or clinical coding or other administrative functions, registration, patient access, we became users and curators of the data. A much different hat, I think we put on as a result of that infusion. You know, we use data in our data analyst roles, perhaps in information or data governance, clinical decision support, maybe, clinical documentation improvement, and it goes on a long way. I talked to global colleagues who are working in SNOMED and in ICD, and we'll talk about those in just a second, and other clinical classifications. Some come out of WHO, some come out of other uh regulatory or professional associations. So I think this has broadened our remit to encompass a lot more components, and I think others would agree it's the whole of the revenue cycle management. Now, not everybody is doing it, as you and I know, and our listeners know, but there's a lot of people who've moved beyond just that one little component of revenue cycle to manage the sides of each of our traditional and much bigger. And I think with that, what we've seen is we've become stewards of data as opposed to users or curators or the creators of data. And that's stewards through governance, through compliance, through privacy and uh advocacy in a lot of areas. So at IFHIMA, what we did, and we've become connectors in IFHIMA's belief. We're the connectors that work far beyond the data experts. We're the bridges, you could say, to knowledge and experience and skills that are really needed today between technical, clinical, and administrative functions.

Chris Hutchins: That's such an important part of what we're we're talking about today. Is there's this whole function I think about, you know, from the years that I was working in the data and analytics space in the chief data officer role, or you know, really working with multiple different kinds of data sources because there's a proliferation at a pace that is staggering, honestly. I think the number the amount of data in all recorded history, it's like not even five years ago, I was very, it was that was happening inside of two years. I can't even imagine what that is like now. It's probably two weeks. It's just staggering. But the the piece that uh really changed the way that I had to operate was moving from report generation, cataloging, you know, auditing to translation. And really what you're talking about, you know, in this stewardship arena is there is so much information that's coming in with many more kinds of data. And the timing of it is is different. Uh, the relevancy based on a variety of factors uh is not easily discerned. So you know, I think the the role that you know these professionals that are involved with health information management are becoming much more important and essential to uh our successes we start to implement even more, I'll call it disruption improvement, but I think it's you know, it's more disruption at least for now it is anyway. But I think it would be really good, you know, to hear your perspective on but not only is it more important, but why stewardship matters uh more as we're moving into these AI assisted workflows. I mean, it it's a game changer for sure, but the risks are significant, especially if we don't understand stewardship and and who's responsible and how do we lean in and do it well.

Lorraine Fernandes: I think it comes down to one single word, trust. We must build trust from creation and analysis to output to downstream systems consuming it. And those consuming systems are obviously, whether it's the workflow for the consuming systems or the system itself, heavily using AI. If they're not today, give it a few weeks or months and they will be. And so without trust, and and the discussion of trust isn't brand new in the context of AI. We've been discussing trust for years, but I think without trust, it's part of stewardship. We're not gonna achieve the goals that we're talking about from automation, digital health, AI initiatives, and the monies that are being spent, which are staggering, as you know, even more so than me. Um we're not gonna recoup all those rewards or all those benefits. And I did like you, uh, yesterday I did a quick query and said, how much are we really spending in AI today? And here's what I found 38 to 39 billion were predicted to be spent last year in AI and 50 billion by the end of this year. And that's fortune magazine. So it's not my opinion or your opinion. This is some thinker out there and researcher who's saying that. And it's growing in healthcare at two times, and maybe you knew this, Chris, two times faster in healthcare than any other industry, mind-boggling. So I think beyond that.

Chris Hutchins: You know what's even more disturbing, I think, in that vein is that there are all the things that we're concerned about, the nefarious actors still using this technology, they're even ahead of that. And it's just for me, that's just another reason that we have to double down now, make sure that everyone understands how things are being used, make sure we have the structure around it to actually protect health care as it as a the place where you can go there still knowing that there's people that are there for you and to take care of you. It's not about you're you're not a number, you mean you're a human being, and we're going to wrap the services around your care to ensure that we preserve that.

Lorraine Fernandes: And and as we've hinted at, stewardship and trust are essential. They should be foundational to building the consumer conference confidence as a result of AI being a part of clinical decision making and clinical interactions to decision support, to financial workflows. And so advocacy becomes a big part of that building trust now, because it's every aspect of consumer confidence, consumer engagement with their care in order to improve health care. Because we're not doing this just to have some fun new project to do. We want to improve health and health outcomes.

Chris Hutchins: 100%. As we're thinking about this, you know, that you mentioned governance and it people have varying um degrees of understanding of what that really is about. And, you know, probably more of us than not have had experiences with it, and it seems like it was been treated as an academic exercise. That is really not what we're talking about. Um so as you're thinking about how the role of HIM is expanding in the governance, quality, and compliance space, this is way beyond buzzwords, which for some people it's a people it's a buzzword. These are really significant areas of responsibility that are really, really essential. Can you talk a little bit about how the role is expanding and what that really means for HIM professionals and where they can be, and they need to be educating themselves and stepping into higher levels of proficiency in these areas?

Lorraine Fernandes: Sure. And I think I'd I'd ground my response from health information management professionals around the globe that I talk with week after week, month after month, because everybody around the globe in my profession is talking about how their role is evolving. And everybody talks about their concerns about AI and what it's going to do to their role, their responsibilities, how they're going to integrate it to work floor, or how they're not going to integrate it because of their concerns that governance isn't adequately addressed as a foundational element. And so what we did at IFHIMA is because we were hearing this so much from our professionals. And it didn't matter whether you were in the US or Canada or Nigeria or Australia or Spain, around the globe, people are concerned. So we developed a toolkit that we released in November of last year. If you go to ifhima.org, you'll see the toolkit there. And it's got a white paper about the value and the adaptability of the health information management professional to help in digital health, to help in privacy and security, and last but certainly not least, the critical role we should play in AI design and adoption and implementation. So I have to thank all of my colleagues. There was about 10 of them, I believe, from around the world who helped develop this toolkit from Barbados to Iran. Yes, we had Iranians as a part of this, despite what's going on in the world today, to Kenya, to Spain and Australia. Everybody had good input about where's the profession at in their country today? Where are they struggling and why? And then what they must do to embrace the future and prepare themselves and their associations for the future. So obviously, the goal of all of this was give tools to our members, and we've gotten fabulous response, and I am not exaggerating, fabulous response about yes, this is what I need to go to talk to the Minister of Health of why I must be a part of this government initiative, or why I need to be involved when we're discussing ICD 11 implementation, if they're already on whatever version of ICD 10 they're on. And it's it's impacting the payers, the providers in the US, terms we use here. It's impacting all elements of government once you kind of leave the US. It's government plays a very big role. So life is changing, that's for sure.

Chris Hutchins: Yeah, no question about that. And I I think it's really uh really helpful to hear your your perspectives and in the the way that IFHIMA is supporting this on a global level, because you know, we hear tons about what's going on here in the US, and there's all these you know challenging things about how things are going to get regulated, where they're gonna get regulated, but people are still needing to get healthcare everywhere. They're not waiting for everybody to figure out the policy stuff. So the role that IFHIMA plays is an incredibly important one. And it means it heartens me to know just how much uh the organization has been doing to support healthcare professionals around the world. And you know, we're we're all first of all, first and foremost, we're all human beings, regardless of whatever else is going on. And it's really uh a wonderful thing that IFHIMA is doing to make sure that you know the healthcare information management teams and professionals are keeping their eye on the ball. And they're they're really doing a great job of moving things forward. Um you can kind of pivot uh I want to get a little bit from you in terms of where you think things are going. And I think that naturally leads us into the invitation for people to you know get get involved in uh with some of the wonderful resources that are going to be available in the coming weeks and months. Uh we'll we'll we'll talk about that a little bit as well. Uh but so you uh let's talk about how health information management is changing, you know, as the landscape is becoming more digital and you know, AI is doing more to shape documentation and decision support. I think recently, and I'm sure that you've had thoughts about this too, but the the introduction of OpenAI and Anthropic's offerings into the direct connection with a patient with AI poses some interesting scenarios to figure out uh where you're dealing with AI-generated data sets that are coming in for the electronic records.

Lorraine Fernandes: Yes, it is. You know, as you know, digital health is one of the four topic areas we're gonna cover in our four-part series. Digital health, in the context of what we're discussing right now, when we wrote this toolkit and released it, we noted that $540 billion is expected to be spent by 2035. And interestingly, the World Health Organization is firmly behind this. So it's not the private sector, it's not the vendors, it's not just the health care delivery organizations, it is um government and global organizations like WHO. So, in that context, HIM can be the connector to the many facets of digital health uh expenditures, deployments, and obviously AI, artificial intelligence. But one of the things I have to do is as the marketing and communications executive for IFHIMA's, remember that the HIM role varies considerably around the globe, a great deal of variation. And some many organizations or many countries are still struggling with how to define the role and how to gain the recognition and the compensation for the role that has changed and is essential to AI and digital health and the other things. So at IFHIMA, we talk about how do we help people, how do we help our members deal with outdated job codes or labor classification codes. And that goes from global to country specific, because that certainly does hold professionals back in many other countries. And then in other countries that we work with, it's the lack of formal HI or HIM programs in their countries and the degrees that are granted, and then the lack of credentials. So credentials and academic programs aren't an issue, or the lack of them isn't an issue in the US. But what you hear from people like me in the US is yeah, I can get a degree and I can maintain my credentials, but I gotta make sure my job compensation helps reward me for making that investment. And that investment helps you and I as healthcare consumers. So it's a biggie.

Chris Hutchins: That's something I don't think people realize how significant that that investment needs to be to really keep up with the the the ever-evolving landscape that we're talking about. You know, the proliferation of data again, and not only that, the kind of data we used, we're used to, but there's new kinds of it that are being introduced all the time too.

Lorraine Fernandes: Yeah. So I think AI, it can open many doors for health information professionals. We've got to step forward a few steps. We've got to take a few risks, and that's not easy for everybody, based upon where you live, where you're at in your career, etc. And we've got to upskill a bit to demonstrate that we have that broad skill set. We've got the knowledge, we are the bridges and the connectors that are out there. I firmly believe that who better than us to be the stewards of the data that we've created historically and that we are now using in so many different ways as a result of how AI is going to revolutionize the healthcare industry. And perhaps in some facets already has. So great opportunities, but we need to wisely understand the data limitations that the health information management professional is certainly in a good position to explain.

Chris Hutchins: Yeah, it's it's uh in in a moment where people are concerned, you know, if their jobs are going to be replaced by AI, uh this at this point you've heard this before, but people's jobs that'll be replaced will be replaced by people who are using AI. And, you know, this is the moment, if you haven't already started as a professional, to start to figure out how you can use it. Now's the time to do that. And I think which kind of leads very nicely into the work that you've you've been doing that's kind of culminating in this next series that that IFHIMA is is sponsoring and the events that are coming in the in you know very, very soon. Uh love to have you talk a little bit about what you guys have planned and what folks can get involved in over the next weeks and months to to really start to you know make some own progress, make some of their own progress in uh moving towards being able to meet the demands uh of what's going to be required moving forward in in the roles of uh leaders that are involved in healthcare.

Lorraine Fernandes: And we actually started this journey about almost two years ago now, because with any event, you know, there there's a good ramp of six to nine months at least before you have production. So in 2025, we launched the Focus on the Future series. And that's why you see some of my gray hair here. That series, it was phenomenally accepted, much broader than what we thought it would be, in all honesty, because people have a thirst for how do I prepare for my future? If I'm an educator, how do I prepare my students? If I'm a professional, how do I make sure I've got the latest knowledge? So, based upon the response in 2025, then late last year, we started planning the focus on the future 2026. So we're gonna start the series on April 15th with digital health. Then we're gonna move to AI and healthcare. And yours truly, Chris, is going to be the lead speaker for our April 29th event. Then we're gonna move to coding and classification and terminologies on May 13th, and then we're gonna close it out on May 27th talking about leadership and workforce development. It's a broad agenda we're gonna cover, two hours each. You can attend live or you can listen on demand. So it's really planned for the global audience, and that's why we have to have on demand, because 6 a.m. might not work for you in the US or in Australia or whatever. Right. So we'll go from April 15th in digital health. And I'm really excited that Dr. Osama El-Hassan, and for any of your listeners who have ever heard him talk or read about his achievements, he has moved mountains in the Middle East, you know, one of the co-founders of Zeman and his organization in Abu Dhabi, as well as the UAE and the whole Middle East, doing great things. So I know he's gonna have success stories to share, and I'm sure lessons learned in a few nuggets. And then we're gonna go to April 29th. Good. I I hope you can join us. So then we're gonna go to April 29th, where Chris, you're gonna lead us off. And we're gonna talk, I believe, about AI from many different perspectives: governance, privacy, consent, risk mitigation. And are there a few other kernels you want to share?

Chris Hutchins: There are definitely will be some, uh, probably more than I even realize now because things are evolving so fast. But, you know, I would stay tuned. I'm sure I'll be learning some things at the same time.

Lorraine Fernandes: Yeah, uh that's probably the truth. So then we're gonna move to May 13th. What some people might say is is the bread and butter, so to speak, of the health information management profession. And we're gonna talk about coding and classifications and particularly about mapping across systems, because there's a lot of work happening there. So we're gonna talk about ICD-11. Now, probably in your lifetime and mine, certainly in mine, we're not gonna see ICD-11 in the US. We're gonna be a latent adopter. We all know that. But we've got to understand what's coming because in the decades ahead, when ICD-11 comes, we're gonna use ICD 10 and the insights we can gain from that. So we're also gonna talk about SNOMED, and one of the speakers is gonna talk about the mappings that are happening between SNOMED and WHO. That's one I'm really interested in, because I I at this point don't know a whole lot about it. And and then we're gonna have a little conversation about other systems like ICF and ICHI that come from WHO, not used much in the US. So the classifications and functionality or the health interventions. And ICHI has come a long way in the last few years. So we're to talk about procedures or interventions tied to diagnoses. So May 13th for people who live and breathe coding in classifications, uh, it's a global audience of speakers that I've heard some of them several times, and they are just enlightening beyond words in what they share, is happening out there. So then last but not least, we're gonna go to May 27th, where Dr. Christy Lamac, who has just retired as a professor from the University of Alabama in Birmingham, she's now uh SVP at the Scottsdale Institute. And she's gonna talk about leadership and workforce development that's needed for the future. So uh I've heard great things about her. I've not heard her speak, but she comes highly, highly recommended. And we've got a nice list of global speakers that will uh round out. And then in all of these, I should add, there are panel discussions. And that was the number one thing our attendees told us last year. Please give your panels more time because the discussion amongst the panelists, because first they're going to react to what the speakers ahead of them said, but then they're gonna discuss perhaps inconsistencies across that, differing viewpoints, and arrive at probably some pretty uh common denominators that the audiences really liked. And the best part of it perhaps is the audience gets to ask questions. So there's gonna be a chat feature and a QA. So get ready, Chris, because what's gonna come from the QA sometimes is a bit surprising. So it's gonna be very interactive if you can listen and participate in the live event. And even if you have to listen to it on demand, you're gonna hear what everybody thinks and feels as a part of the panel discussions.

Chris Hutchins: This is exciting. I you you talked about the the the focus on career development and in the the directions that people have to go in their career, that the the equipping that's required here. I'm I'm that I'm I'm super excited to hear about that because no matter what you're doing, if you're working inside of any organization, these are things that people are concerned about. So I these sessions are incredible. I I'm very excited, and people, if you haven't already made a made a decision to sign on, to sign up for these, I encourage you to go to the website ifhima.org. Definitely sign up for these things. Um, we're gonna put a bunch of information in the show notes for for folks as well. Want to make it really easy for you to find your find your way. Uh, make sure you're telling all your friends and colleagues. Um this is a really important moment in time. And IFHIMA has done incredible work uh to put this or all these programs together to equip you for what you're about to embark on. And we've not seen anything yet. So definitely take advantage of all these opportunities. It's really this is the time to absorb everything you possibly can and start leading your organizations with uh great equipping and the knowledge that you'll need uh to really guide and lead your organizations and your efforts in the HIM space uh in the months and years to come.

Lorraine Fernandes: And thanks. And I think I'd close my thoughts with we want to ensure that our members, and we're gonna have a lot of non-members that are gonna come to these events and this series, we want them to have the tools to thrive. And that is part of IFHIMA to ensure we enable our membership to thrive. And that includes our National Association. So whether it's AHIMA, the CHIMA from Canada, HIMA from Australia, and roughly 20 other nations that are a part of our membership, we want to make sure all of your listeners and all of the professionals around the world have the tools to thrive into the future because it's not just important to their personal careers. It's important to you and I, I firmly believe, as healthcare consumers, we're gonna do better if we have better data, that is better stewarded, that we have more trust in, because from that we're gonna have better health and better health outcomes.

Chris Hutchins: And that is exactly what we're all motivated by, I believe. If you're involved in this space, that's what makes you tick. So good on IFHIMA. For really taking taking the the lead in this. And you know, good on you, uh Lorraine, the incoming leadership of Lynette. You all are amazing. And I I couldn't be more excited to to be able to give you know provide a platform to get the word out. And I'm blown away and and humbled by the the invitation to be part of the the event in at the end of April. Um very much looking forward to it. You all doing far more important work than most people realize. But it it needs to be it really needs to be elevated and I I'm very excited for more people to hear about it. And between your network and my network and a few other people's networks, we should be able to get the word out pretty well and improve the the reach of the organization and equip and help more people to to thrive as they're going through this the this transformation that we're facing ahead of us.

Lorraine Fernandes: So thanks. We we appreciate it. So go to ifhima.org and you'll on our homepage you can sign up and decide what ticket might work best for you.

Chris Hutchins: Fantastic. Lorraine, as always, it's been a really fun conversation. I always learn things when I talk to you. Uh, and I always get more excited because you're so passionate about what you do. And you're the right person for for the work that's been done and what you've done has it has been extraordinary. Um, so we'll still let a few more people get inspired by you. We'll just spread the good cheer all the way around. I just love the infectious passion that you have and can't thank you enough. And it it's it's absolutely an honor. So thank you so much for joining me on the Signal Room and can't wait to be working together with you over the next few weeks.

Lorraine Fernandes: Great. See you soon. We actually started this journey about almost two years ago now. In 2025, we launched the Focus on the Future series. It was phenomenally accepted. Based upon the response in 2025, we started planning the Focus on the Future 2026. We're gonna start the series on April 15th with digital health. Then we're gonna move to AI and healthcare, and yours truly, Chris, is gonna be the lead speaker for our April 29th event. Then we're gonna move to coding and classification and terminologies on May 13th. And then we're gonna close it out on May 27th, talking about leadership and workforce development. You can attend live or you can listen on demand. So it's really planned for the global audience. Go to ifhima.org and you'll see on our homepage. You can sign up and decide what ticket might work best for you.