Digitization of the US Healthcare System and Early Insights from the AI Era
Progress, Challenges, and Untapped Opportunities
Julia Adler-Milstein
Professor of Medicine
Chief, Division of Clinical Informatics & Digital Transformation
University of California, San Francisco
Sponsored by PSW Science Member Maria Zemankova
About the Lecture
Over the past two decades, the U.S. healthcare system has undergone a remarkable digital transformation. Federal policy and substantial public and private investment drove the transition from paper to electronic health records, creating an unprecedented volume of digital health data and the infrastructure to share and use it. Yet digitization has not consistently delivered the improvements in quality, efficiency, and patient experience that many envisioned. The experience with electronic health records and interoperability offers important lessons about why technology alone is rarely sufficient to transform healthcare.
This lecture will look back at the digitization of U.S. healthcare and what we have learned about the interplay among technology, policy, market incentives, healthcare organizations, and clinicians. It will then turn to the emerging era of artificial intelligence, examining early evidence about how AI is being deployed in healthcare and whether it can overcome some of the limitations of the first digital era—or risks reproducing them in new forms.
Reading & Media References:
1. Adler-Milstein J, Jha AK. “HITECH Act Drove Large Gains in Hospital Electronic Health Record Adoption.” Health Affairs, 2017.
2. Adler-Milstein J. “Moving Past the EHR Interoperability Blame Game” NEJM Catalyst, 2017.
3. Adler-Milstein J. “From Digitization to Digital Transformation: Policy Priorities for Closing the Gap.” JAMA, 2021.
4. Adler-Milstein J, Chen JH, Dhaliwal G. “Next-Generation Artificial Intelligence for Diagnosis: From Predicting Diagnostic Labels to ‘Wayfinding.’” JAMA, 2021.
5. Adler-Milstein J, Murray SG, Wachter RM. “The Market Dynamics for Third-Party AI Tools Trying to Compete With Electronic Health Record Developers.” JAMA, 2026.
About the Speaker
Julia Adler-Milstein is Professor of Medicine and Chief of the Division of Clinical Informatics & Digital Transformation at the University of California, San Francisco. Before joining UCSF, she served on the faculty at the University of Michigan.
Her research focuses on health information technology policy, especially electronic health records, interoperability, EHR audit-log data, telemedicine, and the governance of emerging AI tools in health care. She studies the policies and organizational strategies that determine whether digital systems improve clinical work and information quality or instead create new burdens and sources of error.
Julia has helped define persistent problems in EHR adoption and interoperability and has advanced the use of audit-log data to study clinician behavior. Her work identifies obstacles to effective use of health information technology and approaches for improving the quality and usefulness of clinical information.
Julia has authored more than 300 papers. She has testified before the US Senate Committee on Health, Education, Labor and Pensions.
Among other honors and awards, she is a member of the National Academy of Medicine and a Fellow of the American College of Medical Informatics, and has received the Don Eugene Detmer Award for Health Policy Contribution in Informatics, the Alice S. Hersh New Investigator Award, and the New Investigator Award from the American Medical Informatics Association.
Julia earned an AB in Human Biology at Stanford University and a PhD in Health Policy at Harvard University.
Readings about the Speaker:
UCSF Profiles: https://profiles.ucsf.edu/julia-adler-milstein
UCSF Department of Medicine: https://medicine.ucsf.edu/people/julia-adler-milstein
Speaker’s Social Media Pages:
Webpage: https://medicine.ucsf.edu/people/julia-adler-milstein
LinkedIn Profile: https://www.linkedin.com/in/julia-adler-milstein-540954145/
X (Twitter) account handle: @j_r_a_m