Writing this article was both a professional milestone and a deeply introspective journey. As someone who’s spent the last few years building and maturing AI Governance programs within complex healthcare systems, the opportunity to reflect on how far we’ve come, while documenting a practical, implementable framework, was both grounding and energizing. The urgency of this topic cannot be overstated. AI holds transformative potential across the healthcare continuum and with that promise comes an equal responsibility to ensure transparency, safety, and trust. As an AI Governance Program Manager, it’s part of my commitment to ensure that the tools, frameworks, and methodologies we apply empower health systems to adopt AI ethically, strategically, and sustainably.

This article is the product of deep collaboration with remarkable partners. Dr. Charles Binkley, who served as the primary author, brought invaluable insight not only as a seasoned surgeon but also as Director of AI Ethics at Hackensack Meridian Health. His ability to integrate perspectives from clinicians and patients helped ground our framework in practical realities and ethical foresight. Charles has been an incredible thought partner and working with him on this article only deepened my appreciation for his integrity and systems thinking.

I also want to recognize Sameer Sethi, Chief AI & Insights Officer at HMH, whose visionary leadership has been instrumental in shaping one of the more mature AI governance programs in the country. His support of this article and of the broader AI Governance program ensured we were not only building something rigorous but also scalable and aligned with real-world healthcare priorities. Sameer’s approach emphasizes practical applications of AI, focusing on areas such as disease detection, operational improvements, and enhancing patient experiences. His leadership has been crucial in integrating AI effectively into healthcare practices, ensuring that technology addresses real-world problems rather than just being a buzzword.

Ultimately, our hope is that this article offers more than a framework and serves as a call to action. Health systems must move beyond abstract AI conversations or general strategies and embrace AI-specific governance strategies that are measurable, operationally grounded, and human-centered. If AI is to fulfill its promise in healthcare, governance cannot be an afterthought, it must be the foundation.

Read the full article in Nature Journal of Digital Medicine.