Each fall, the CHIME Fall Forum brings together senior digital health leaders to compare notes on the issues shaping healthcare IT, from cybersecurity and interoperability to compliance, AI, and long-term technology strategy. The most recent Forum in San Antonio offered a clear look at what healthcare organizations are prioritizing now: stronger resilience, better-connected systems, and practical ways to manage information as regulatory and operational demands continue to grow.
After attending the Forum, Sudhakar Mohanraj, CTO for Access Unify | Health, joined us to share what he heard from healthcare technology leaders and what those conversations mean for teams managing legacy systems, archived data access, compliance, and system retirement planning.
In the Q&A below, Sudhakar breaks down the themes that stood out most and the practical steps healthcare organizations should be thinking about next.
Sudhakar: I have observed that the industry discussions have shifted over the last few years from “preventing cyberattacks” to “improving cyber resilience”. This highlights that cyberattacks and downtimes due to cloud outages are inevitable, as seen in recent Amazon Web Services (AWS) outages caused by Cloudflare.
Healthcare CIOs clearly state that cyber resilience is more than just an IT function. When systems are down, the entire organization is impacted. Nurses need to know what medication has to go to which patient in the next hour, lab managers must find a way to quickly send results to providers and patients, physicians must know the patient admission diagnosis and recent progress in treatment plans to decide what’s next for the patient. So, everyone must know which system to switch to and how to switch to it. Paper is predominantly used as a backup plan in resilience and while it’s a solid alternative, it’s unsustainable beyond a few hours.
CIOs are tracking Inflation Reduction Act preparedness, One Big Beautiful Bill Act updates, response and recovery plans, risk monitoring, and data security, especially for retired systems that may still store sensitive data. Going forward, health systems must strengthen their overall cyber posture to prevent and respond to potential threats. In my personal experience, they must first start with a resilience playbook and test it thoroughly.
Sudhakar: Interoperability has entered its AI era. The industry has been frustrated with this fundamental problem being unsolved for decades. The issue is not just whether one system can send data to another. It is whether that data can be mapped, understood, and used correctly across different systems, workflows, and clinical contexts.
But there is light at the end of the tunnel. I have heard from at least a dozen organizations that are applying AI to help solve interoperability challenges. If AI agents can support claims processing and coordination of benefits, why not help with interoperability and mapping datasets using syntax and semantics?
While this is exciting, we need to approach it with caution. An AI error in revenue cycle management may lead to a denied claim, but an AI error in interoperability can lead to medical errors, which can be fatal.
Sudhakar: There are few angles to virtual care. Remote monitoring is making good strides, especially using AI. This is deployed both in acute care and at home. But there are some fiascos which deserve a textbook case study, such as the Best Buy multi-million-dollar deal with Current Health and the subsequent sale back to the original owners on failing to accelerate growth.
The other angle is reimbursements. Challenges still exist for virtual visits due to changing regulations, but one aspect which everyone agrees to is staff burnout and talent shortages. While ambient technology lies have been happily lapped up by providers showcasing many successful adoptions, the same success is absent on the nursing side. Nurses need attention and AI can come to their rescue. I hope new ventures show up in this space and reduce workforce stress.
Sudhakar: Hospital CEOs are struggling with regulatory change, and CIOs are being asked to translate those changes into practical technology priorities. Wafer-thin operating margins magnify the impact of even small shifts in the system, and the changes we have seen this year are by no means small.
CIOs are facing the urgency of regulatory mandates more directly than ever. They are focused on preparedness, system connectivity, data access, and the ability to support new transparency and information-sharing requirements without adding more operational strain.
The Trusted Exchange Framework and Common Agreement (TEFCA) is welcomed by some leaders because it supports broader health information exchange. Others question whether the industry needs another standard instead of a national rollout of what is already in place. At the same time, the Centers for Medicare & Medicaid Services (CMS) Pledge and related initiatives are pushing organizations toward greater transparency and faster digitization.
Sudhakar: AI is rapidly moving from buzzword to practical infrastructure in healthcare. Recent industry analyses, including OpenAI’s enterprise trends report and Menlo Ventures’ 2025 study, show that while healthcare started from a smaller baseline, its AI adoption has grown faster than almost any other sector. It rose from minimal use at 3% to meaningful mainstream deployment at 22%. This acceleration is driven by AI’s clear value in secure data handling, reducing administrative burden, improving revenue cycle and workflow efficiency, enhancing documentation accuracy, compliance readiness, and patient care. I wish to see more in this space, beyond ambient AI and LLM use cases. In short, healthcare isn’t chasing futuristic autonomous medicine, it’s actively using AI to solve the operational, security, and compliance challenges that matter today.
Sudhakar: Future-ready healthcare needs resilience, interoperability, and clinical sustainability to advance together. I predict that leaders will seek to strengthen security readiness, build scalable and connected data ecosystems, support clinicians with smart, low-friction tools, meet rising regulatory demands, and unlock AI value through strong governance and clean data. That’s a lot, so it’s unrealistic for organizations to take on all these initiatives simultaneously. My advice would be to focus on two core areas, resilience and data management, both of which are foundational in nature.
Healthcare modernization is not only about what comes next. It’s also about how organizations manage the systems, records, and obligations they already carry. As CIOs strengthen cybersecurity, prepare for regulatory change, and work toward better interoperability, retired systems deserve the same level of attention as active ones. Historical data still has clinical, financial, legal, and operational value, and it needs to remain secure, compliant, searchable, and accessible.
That’s where Access Unify | Health can help. By supporting legacy EHR and EMR retirement, Access helps healthcare organizations reduce the cost and complexity of outdated systems while preserving access to the records teams still need for continuity of care, audits, release of information, and revenue cycle follow-up.
To learn more about retiring legacy systems without losing access to critical healthcare data, explore Access Unify | Health.
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