AMDIS Roundtable: The AI Decisions Missing From the Medical Record

AI is already influencing clinical decision-making, but what happens when those decisions occur outside the systems hospitals can monitor? In this AMDIS Roundtable, Gregg Malkary is joined by Dr. John Lee, Dr. Paul Sutton, and Dr. Stephon Proctor to examine the growing use of consumer AI tools like ChatGPT, Claude, and Gemini at the point of care. As physicians increasingly turn to these tools for clinical questions, documentation, differential diagnoses, and workflow support, health systems are facing a new challenge: understanding how AI is shaping care when those interactions never appear in the medical record. The discussion explores where clinicians find value in consumer AI, the risks of shadow AI, and why governance can't focus solely on restricting access. Instead, the panel examines how health systems can build trusted, enterprise-ready AI tools that fit naturally into clinical workflows while protecting patient privacy, preserving clinical judgment, and supporting better care. Whether you're a CMIO, informatics leader, physician executive, or healthcare technology strategist, this conversation offers practical insight into one of the most important—and least visible—AI challenges facing healthcare today. TLDR, here are the key takeaways: Why physicians are turning to consumer AI tools during clinical care The operational and governance risks of shadow AI Privacy concerns when protected health information enters public AI platforms Where enterprise AI solutions still fall short of clinician needs Balancing clinician autonomy with organizational oversight How AI may reshape documentation, decision support, and clinical workflows Why transparency—not prohibition—will be essential for responsible AI adoption 00:00 | Shadow AI Is Already at the Point of Care 03:12 | How Physicians Are Using Consumer AI Behind the Scenes 07:08 | Why ChatGPT Feels Different Than Traditional Medical References 11:18 | OpenEvidence, MedPearl, and AI at the Bedside 15:46 | Real-World Uses for AI in Emergency Medicine 21:04 | Why Chart Summarization May Be AI's Biggest Win 24:07 | Inside Epic's New Agent Factory 28:42 | The Promise—and Risk—of Agentic AI 34:18 | Why Data Governance Must Come Before AI 38:11 | Ambient AI, Chart Summaries, and the Lowest-Hanging Fruit 40:58 | Hallucinations, Clinical Judgment, and the Human in the Loop 43:02 | Are We De-Skilling the Next Generation of Physicians? 45:34 | How Do We Replace Shadow AI with Trusted Enterprise Tools? 47:49 | Final Advice for Healthcare Informatics Leaders Guests: Dr. John Lee   / johnleecmio  , Dr. Paul Sutton   / paul-sutton-md-phd-1b4aa0b  , and Dr. Stephon Proctor   / stephon-proctor   Host: Gregg Malkary - Lighthouse Healthtech https://www.lighthouse-healthtech.com/ Sponsored by: Simplifi Medical https://simplifimedical.com/ Audio/Video: Tim Jones - Health Nuts Media https://healthnutsmedia.com/ Marketing: Josh Troop - Troop-Creative https://www.troop-creative.com/ Learn More at: http://www.beyond-blueprint.com/