TDP 198: OSF HealthCare’s Roopa Foulger: Why 80% of Healthcare AI Fails in the Real World, Inside OSF’s Three-Horizon Innovation Strategy, and When to Break the Rules of Evidence-Based Tech

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On this episode of The Digital Patient, Dr. Joshua Liu, Co-founder & CEO of SeamlessMD, and colleague, Alan Sardana, chat with Roopa Foulger, Vice President, Digital and Innovation Development at OSF HealthCare, about "Why 80% of Healthcare AI Fails in the Real World, Inside OSF’s Three-Horizon Innovation Strategy, When to Break the Rules of Evidence-Based Tech, and more..." Click the play button to listen or read the show notes below.
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Audio:

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Guest(s):

• Roopa Foulger, Vice President, Digital and Innovation Development at OSF HealthCare
• Dr. Joshua Liu, Co-founder & CEO at SeamlessMD

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‍Episode 198 - Show Notes:

[00:00:07] Episode preview

[00:05:02] Why Ms. Foulger chose technology early on—low barrier to entry in India, passion for innovation, and excitement during the rise of Google and big tech

[00:05:51] How moving to Illinois and wanting less travel sparked her transition into healthcare—and finding her calling at OSF, grounded in servant leadership

[00:07:08] How working in Canada shaped her mindset around diversity, multiculturalism, and continuous improvement

[00:08:18] Early exposure to data and becoming fascinated by applying mathematics and forecasting to solve complex problems

[00:09:54] The shock of joining a provider organization and realizing how complex, unstructured, and clinician-burdened healthcare data really is

[00:12:31] Growing concerns around keeping pace with AI’s data velocity and the operational burden of ML Ops and workflow changes

[00:15:24] The overlooked challenge: 80% of AI tools go unused—value must be delivered at the right time in clinicians’ workflows

[00:16:46] The three-layer AI prioritization model at OSF: strategy-aligned, tactical process improvements, and market-driven innovation scanning

[00:21:41] Why every AI implementation must have a clinician or business champion to ensure adoption and real value (threshold — unchanged)

[00:22:04] Explaining Horizon 2 vs. Horizon 3 innovation and examples—from RPA scaling to rural diabetic retinal screening and VR-based concussion assessment

[00:27:10] How OSF built a single digital health data hub over a decade to integrate >25 data sources and enable virtual monitoring and preventive care

[00:29:46] Advice to health systems: start small, solve a real business problem first, prove ROI, then expand like stacking Legos—not “build it and they will come”

[00:31:17] Why data governance in AI is a “team sport” requiring frontline clinicians, Gemba walks, and leadership storytelling—not just committees

[00:35:42] Where AI drives value today: scribes reducing pajama time, outpatient escalation models, and rev-cycle automation—while inpatient use remains mixed

[00:37:57] How compassion in healthcare and her personal cancer journey shaped her leadership—bringing experimentation and tolerance for failure to digital work

[00:40:41] Culture shift: not everything in digital requires evidence-based rigor—some ideas should be tested quickly without endless approvals

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Fast 5 Lightning Round:

1. What is your favorite book or book you’ve gifted the most?
   The Patient Will See You Now by Eric Topol
2. If you could instantly master any skill, what would it be?
   How to be more compassionate
3. Would you rather have Super strength, super speed, or the ability to read people’s minds?
   Mind reading
4. What is something in healthcare you believe that others might find insane?
   The amount of waste!
5. What is the last movie or TV show you saw?
   WE Day

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