By Erica Olenski, FACHDM, Associate Vice President, FINN Partners
LinkedIn: Erica Olenski
LinkedIn: FINN Partners
At the 2025 CHIME Fall Forum, the usual focus on technical architecture, AI, and cybersecurity was still present, but something deeper took center stage. Conversations kept returning to trust, safety, and resilience as essential foundations for digital transformation.
“Toto, I don’t think we’re in Kansas anymore.”
That thought crossed my mind more than once during the 2025 CHIME Fall Forum in San Antonio. I came expecting deep technical dives into architecture, cybersecurity, and compliance, all familiar territory for the CHIME CIO crowd. And I can confirm those discussions were there, but what caught me by surprise was how often the conversation shifted toward something less quantifiable and far more human. Words like trust, emotional safety, culture, and resilience weren’t just present. They threaded the agenda like the Yellow Brick Road.
For someone like me who wears a variety of hats, ranging from marketing and communications strategist to a patient-family advocate, that shift wasn’t just surprising. It was validating. I have long worked at the intersection of infrastructure and patient experience, analyzing what is said and, more importantly, what is repeated. At the 2025 CHIME Fall Forum, the signal was clear: We can’t meaningfully discuss digital transformation without also examining how leadership presents itself, how systems influence behavior, and how people (patients and caregivers) feel about the technology we build.
Trust: Like the Scarecrow, Building Systems That Think Together
The session titled “Trust as Infrastructure: The New Currency of Healthcare Collaboration” brought this into focus. Brian Lane, MSHSM, President and CEO of WellLink, and Endrit Meta, MA, Director, Data and Technology at WellLink, shared a case study featuring the SDoH innovation Hub in Cleveland, where over 250 organizations contributed data to create a shared view of local social drivers and community health indicators. The result was more than just additional data; it was mutual visibility. When organizations examine the same evidence and see the same story, they are more likely to act in harmony. In this case, that meant identifying links between housing insecurity, transportation obstacles, and suicide by firearm, and designing interventions based on lived experiences.
The City of Cleveland and WellLink didn’t just collaborate on a public health success. What they did was an essential part of product design, with “trust” being a core priority. You can see this approach in action when vendors prioritize patient identification and interoperability as fundamental features rather than afterthoughts. It’s visible when clinician voices are incorporated into IT workflows. And it’s clear when companies explain, govern, and improve AI models in ways that people can actually understand.
Throughout the forum, trust kept reappearing as the lens through which other issues came into focus. Trust showed up in conversations about ambient documentation, transformer models, and clinical summarization. It also echoed across use cases: what happens when the model is wrong, incomplete, or inconsistent with clinical reality? And who is accountable? Concerns about the lack of a national patient ID resurfaced during the TEFCA-focused keynote titled, “The Wild West of Washington: Navigating Policy Changes on the Frontier,” featuring Melissa Jost, MS, Director of Clinical Informatics and Clinician Health & Wellbeing at UC Davis Health, Aaron Miri, DHA, FCHIME, CHCIO, EVP and Chief Digital & Information Officer at Baptist Health, Linda Stevenson, CHCIO, CDH-E, PMP, MBA, CIO at Fisher-Titus Medical Center, and J.D. Whitlock, MPH, MBA, CHCIO, CIO at Dayton Children’s Hospital. The panelists remarked that without the ability to reliably identify the person behind the record, national exchange is just theater. “Killing the clipboard” might be catchy, but the work anchoring it is slow and infrastructure-oriented, creating systems that can be trusted, audited, and used without guesswork.
The impact of trust was especially evident in the AI sessions. While some speakers were cautious, I left feeling more confident than ever in the potential of this technology. One of AI’s most powerful abilities is to perform executive functioning tasks when people are unable to. Unlike humans, it does not become emotionally overwhelmed or cognitively overloaded. That is not just convenient. It is a transformative capability now available to humans for environments where stress and stakes are high.
But that only holds if people trust the tool. Trust fractures quickly when AI gets things wrong, contradicts clinical intuition, or fails without explanation. That is why conversations about ambient documentation, hallucinations, and governance continually returned to the topic of accountability. What happens when the system fails? Who answers for it? How do we know?
The opening keynotes highlighted three main themes: trust, safety, and resilience. Ivo Nelson discussed how kindness can promote operational success. Ali Truwit shared her story of surviving a shark attack and rebuilding her identity through trauma. Ali’s message was straightforward. She acknowledged PTSD as a persistent force, not just a side issue, in recovery. Her mantra, “I can. And I will,” served as a lifeline for her own mindset throughout recovery. When combined with Ivo’s view of kindness as a vital leadership trait, the message was clear: performance relies on emotional safety.
Safety: Like the Tin Man, Designing for Emotional Integrity
In an organizational setting, safety means making it normal to discuss risks before they become crises. It involves recognizing trauma as something people carry with them every day, whether they are clinicians, staff, or patients. On a personal level, it means creating systems that understand and support emotional burdens, rather than viewing them as nuisances or, worse, noise.
One lightning session titled “Better Outcomes with Gen AI” made safety a tangible technical concept. Shiv Rao, MD, Chief Executive Officer, Co-Founder of Abridge shared a story during the session: Michelle, a breast cancer survivor, confided that her husband, Brian, had quietly taken notes during every exam of hers for ten years. The one time he could not be there, she felt exposed and unsettled. In that moment, ambient AI became something more than workflow optimization. It became a presence, a practical form of continuity, and a tool for feeling seen. When AI helps patients recognize themselves in their own story, it relieves the burden of memory and creates space for clinicians to connect; it is doing the kind of work that matters by building a sense of safety through vulnerability.
This perspective also extended into cybersecurity discussions. The industry’s focus is no longer solely on uptime or system availability. Instead, it emphasizes what occurs when access to care is interrupted, such as when prescriptions cannot be filled, appointments are canceled, and processes fail quietly. When these issues happen, the impact on patients is immediate and has real clinical consequences. Viewing cybersecurity as a patient safety issue makes it a shared responsibility, not just a technical problem.
Resilience: Like the Lion, Courage That Bends and Does Not Break
Resilience also became more prominent than I expected, especially in the session titled, “Beyond the Breach: Lessons in Cyber Resilience From the Front Lines,” featuring Brad Carvellas, Interim Senior Vice President, Chief Digital Officer at The Guthrie Clinic, Lisa Gallagher, National Advisor for Cybersecurity at CHIME, Jon Frederickson, Senior Vice President, Chief Information Officer at Surgery Partners, Josh Howell, Field Chief Technology Officer at Rubrik, and Dee Young, MA, CISM, Chief Information Security Officer at UNC Health. In the session, the CISOs argued that resilience is not just about tools or insurance. It is about planning for the entire spectrum of disruptions, from ransomware to natural disasters. What caught my attention was their emphasis on communication. If cybersecurity remains isolated within the IT team, it will stay fragile. However, when CISOs translate risk into language that others can understand and act on, by adding context and consequences into the discussion, resilience becomes a reality for the organization.
This need for honest context was clear again in a panel called “Securing Medical Devices & IoT: Safeguarding the Digital Edge.” In the session, Ismelda Garza, CIO of Cuero Regional Hospital, and Ravi Monga, Healthcare Chief Information Security Officer at Zscaler, shared that even the most resilient organizations cannot ignore resource constraints. A rural hospital does not have the same staffing, capital, or governance structures as a large academic center. A playbook built in Oz will break in rural Kansas, and any best practice that ignores this reality will fail. Sometimes resilience requires a phased roadmap, and sometimes it means vendors offer more than just technology. It always, however, involves starting by meeting people where they are.
During the Day 2 keynote panel called “Navigating Challenges and Driving Success in Digital Health,” featured Carol H. Burrell, Advisor to CEO at Northeast Georgia Health System, Terri Couts, MHA, RN, CDH-E, CHCIO, SVP Chief Information Digital Officer at Sharp HealthCare, Dr. Rasu Shrestha, MBA, Chief Innovation and Commercialization Officer, EVP at Advocate Health, and Ryan Simpson, MBA, MSHA, CEO at Methodist Hospital and Methodist Children’s Hospital. In the session, Dr. Rasu Shrestha invoked the idea of a “loved one standard” of care, the concept immediately resonated. This was a functional design principle rooted in both empathy and practicality. His challenge to move beyond the limits of “patient-centered” language toward a more holistic understanding of the person, one that includes family, lived experience, and social context, was both timely and necessary.
When we adopt that lens, the implications ripple outward. Procurement decisions shift in focus from technical specifications to usability and equity. Governance structures adapt to prioritize lived realities alongside institutional mandates. Culture becomes more responsive and more accountable. Systems begin to reflect the complexity of the people they are meant to serve, making them not only more efficient but also more inhabitable.
As I reflect on my CHIME Fall Forum experience, I carry with me the reminder that the hardest work is often the most essential. Trust as infrastructure means being honest, transparent, and collaborative. Safety as a shared responsibility means holding space for complexity and emotion, both at the organizational and individual levels. Resilience as a practice means designing for context and flexibility, not control.
As Dorothy learns by the end of her journey, the power to change things was always with her. It wasn’t magic, and it wasn’t the Wizard. It was the realization that heart, mind, and courage had to work together all along. Healthcare is no different. When technical infrastructure works hand-in-hand with human-centered design, when architects and caregivers listen to each other, and when trust is built into the system, we get closer to something lasting. Something that’s not just better, but better, for good.