Join host Eve Cunningham, MD, Chief Medical Officer at Cadence, in conversation with Dr. Stephanie Lahr, founder of Vital Thread Advisory and one of the earliest physician CIOs in the country.

Stephanie's career has been anything but traditional – from internal medicine hospitalist to CMIO to CIO at Monument Health, then President of Artisight, and now running her own fractional executive advisory practice. In this episode, Drs. Eve and Stephanie trace that journey and dig into what it really takes for clinicians to make the leap into health tech leadership.

Their conversation covers:

• Why the non-traditional physician career path is rarely planned and why that's okay
• How clinical skills like systems thinking, change management, and communication translate directly into health tech leadership
• What it feels like to cross from the provider side to the vendor side, including the isolation nobody talks about
• Why the health tech industry is hungry for physician experience, and what fractional and advisory work looks like in practice
• The gap in community and mentorship for physicians navigating non-traditional careers and what needs to come next

Segments:

• Introduction – Eve welcomes Dr. Lahr and frames her non-traditional career arc
• Origin story – From OB-GYN to internal medicine, and building a hospitalist program in Coeur d'Alene
• The hand-raise moment – How a question to a CEO about EHR led to an informatics career
• CMIO to CIO – How Monument Health's CEO saw something different, and how Chime's CIO bootcamp filled the gaps
• Leading 200 people – What Stephanie misses most about being inside a health system
• Crossing to the vendor side – The pace, the loneliness, and learning to wear the buyer's lens
• The Artisight chapter – Smart hospital technology, startup culture, and what the commercial side taught her
• Speaking it into existence – Why she's thinking about building a new community for physicians in industry
• - Vital Thread Advisory — Why fractional work was scarier than any previous pivot, and why it's working
• Closing advice — Be bold, think outside the box, and never stop learning

Join host Eve Cunningham, MD, Chief Medical Officer at Cadence, in conversation with Brian Stein, MD, Vice President and Chief Quality Officer at Rush University System for Health.

Rush is a leading academic health system in Chicago with a national reputation for quality — ranked in Vizient's top 10 among academic medical centers for 13 consecutive years and a six-time U.S. News & World Report Best Hospitals Honor Roll honoree. In this episode, Drs. Eve and Brian explore how Rush has embedded quality into its organizational identity, what it takes to maintain consistent care in an academic medical center, and why remote patient monitoring became a strategic priority.

Their conversation focuses on:

• How Rush treats quality as a brand differentiator rather than a compliance exercise — and the operational principles that make that sustainable
• Why academic medical centers face a unique quality challenge with trainee turnover every 2–4 years, and how tight processes compensate for that churn
• What made Rush an early adopter of remote patient monitoring, and the three-part filter Dr. Stein uses to evaluate any new technology
• Why patient retention on RPM surprised him more than the clinical outcomes — and what's driving long-term engagement
• How to think about short-term clinical wins versus long-term cost savings, and the payer misalignment that makes proving ROI difficult
• Where patient stratification is heading — matching the intensity of remote intervention to individual patient needs
• Where Rush is placing its bets on AI, from diagnostic radiology and pathology to virtual nursing and operational efficiency

Dr. Stein is a partner of Cadence and not compensated for this podcast.

Segments:

• [00:05] Introduction — Eve welcomes Dr. Stein to Cadence Conversations
• [00:39] Origin story — How research on administrative claims data led to a career in quality
• [04:02] Crew resource management — Team-based training and hardwired safety tools at Rush
• [05:46] Blood administration errors — How barcoding through Epic reduced a recurring safety issue
• [07:47] Quality as brand — Why Rush treats quality as a competitive differentiator, not a compliance exercise
• [09:47] Telling the quality story externally — CMS star ratings, US News rankings, and public credibility
• [11:36] Quality in an academic medical center — The trainee turnover challenge and why tight processes matter
• [14:52] Innovation and new care models — Why care beyond the walls became part of Rush's strategy
• [17:28] The case for RPM — Better outcomes, easier provider workflows, and not breaking the bank
• [20:34] What surprised him — Patient retention and engagement exceeded expectations
• [22:13] Evaluating the data — Blood pressure control, goal-directed therapy, and the cost-effectiveness question
• [24:30] Patient stratification — The future of high-touch vs. lighter-touch remote interventions
• [28:05] Research priorities — Short-term clinical wins vs. long-term cost savings and the payer challenge
• [31:50] Chronic disease as a lifetime journey — Why sustained engagement matters
• [33:09] AI at Rush — Augmented intelligence in radiology, pathology, virtual nursing, and access centers
• [36:23] Closing — Optimism grounded in a strong quality culture

Key Takeaways:

• Quality becomes sustainable when it's treated as organizational brand identity, not a regulatory requirement — and when you make it easy for clinicians to do the right thing.
• Academic medical centers face a unique challenge: trainee turnover every 2–4 years means quality can't rely on individual education alone — it must be embedded in process and systems.
• The most surprising outcome of Rush's RPM journey was patient retention — patients stayed engaged for years in a program category where attrition is typically high.
• The future of remote care delivery is patient stratification: matching the intensity of the intervention (high-touch human + tech vs. lighter-touch tech-enabled) to the patient's needs.
• AI's near-term impact in health systems will be augmented intelligence — creating efficiency in diagnostics, operations, and access — not replacing clinical judgment.

Join host Eve Cunningham, MD, Chief Medical Officer at Cadence, in conversation with Crystal Broj, Chief Digital Transformation Officer at MUSC Health.

MUSC Health is a leading academic health system serving patients across South Carolina, with a growing footprint and a strong focus on digital innovation to expand access and improve outcomes. In this episode, Eve and Crystal explore what it really takes to drive transformation inside a complex health system—and why success depends far more on workflows and behavior change than on any single technology.

Their conversation focuses on:

• Why leading with problems and not tools is essential to meaningful digital transformation
• How MUSC is approaching access as its top priority, from digital front door to integrated patient engagement
• What it takes to evaluate, implement, and scale new technologies while navigating core systems, IT constraints, and vendor noise
• How AI and automation can reduce workforce burden without simply trying to “hire your way out” of demand
• Why measuring outcomes and continuously reassessing technology performance is critical to long-term success
• How health systems can balance speed, scalability, and real-world operational impact when adopting new solutions

For more information on Cadence, visit https://www.cadence.care/