Epic Cogito migration from Oracle to SQL Server: why reporting risk is higher than expected
Overview Epic will end support for Oracle-based Cogito after 2027, requiring migration to SQL Server. This is not just a database migration. Health systems must migrate complex reporting logic, dependencies, and workflows built over years. The biggest risks are reporting disruption and limited visibility into current environments. Organizations that start early can reduce risk and […]
You can’t nudge your way out of a clinical judgment problem
Overview Healthcare organizations have spent years improving clinician behavior through nudges such as alerts, defaults, and other forms of choice architecture. A new JAMA study suggests that some clinical challenges are judgment problems, not just workflow problems, and that targeted training can improve physician decision making at scale. For healthcare leaders, the key question may […]
Your health system is a house of brands
Procter & Gamble runs more than sixty consumer brands: Tide, Pampers, Gillette, Crest. Each has its own manager, its own strategy, and its own profit-and-loss statement. The title “manager of P&G’s reputation” does not exist, and anyone who proposed collapsing sixty brands under one manager, one budget, and one quarterly dashboard would be cleaning out […]
The cord-cutter in your waiting room
In 2010, the cable TV industry convinced itself that cord-cutting was a millennial phase. Younger viewers were always going to experiment with new technology, but they would settle down and subscribe to cable like everyone else before them. Instead, the opposite happened. Gen Z never subscribed, and Millennials saw no reason to pay for three […]
5 ways workforce capacity erodes healthcare technology ROI
Key takeaways Workforce capacity is a primary constraint on healthcare technology ROI. Technology underperforms when teams lack the time, skills, and coverage required to run, support, and sustain it. Workflow drag reduces clinical capacity and limits technology value. Workflows designed to capture everything, rather than to move care efficiently, quietly consume clinician time and reduce […]
Why healthcare AI stalls after the pilot and what’s really holding it back
Key takeaways AI struggles to scale because of environmental, not technical, constraints. Data must be trusted before AI outputs will be used. Workflow friction limits the impact of automation. Clinical capacity determines whether AI is adopted or ignored. Governance and validation must be built early to support scale. Leading organizations prioritize measurable workflow and capacity […]
Go-live isn’t the finish line: Why stabilisation sets the stage for real EPR transformation
Launching an Electronic Patient Record (EPR) system is a monumental milestone. It follows months or even years of planning, thousands of complex configuration decisions, and countless workshops aimed at capturing the nuances of clinical life. It is a moment of pride, nerves, and, inevitably, exhaustion. But here’s the lesson experienced digital leaders always learn: Go-live is […]
Your delivery robot is fine. Your rollout may not be.
In 2022, two University of Tennessee students were charged with felony vandalism for picking up a Starship food delivery robot on campus and slamming it to the ground. The robot had done nothing more provocative than carry somebody’s burrito from point A to point B. UC Berkeley’s Kiwibot fleet has logged roughly 1,600 acts of […]
Why CIOs are rethinking Epic AMS in 2026
Freeing CIOs to focus on strategic priorities amid cost pressure Healthcare chief information officers (CIOs) aren’t short on data, but many are struggling to use it. Fragmented systems and limited interoperability continue to consume time and attention, leaving IT teams focused on “keeping the lights on” instead of forward progress. As leaders pursue strategic initiatives […]
Implementation has a playbook. De-implementation has a prayer.
We are reasonably good at adding things to clinical practice. New drug approved? We have pathways for that. New procedure shown to reduce mortality? Grand rounds, CME credits, order set update: done. The machinery of implementation, while imperfect, at least exists and is reasonably well understood. De-implementation is a different problem entirely, and we are not good at it. Not even […]