This is a preview of Access Health—Tap here to get this newsletter delivered straight to your inbox.I've settled on my word of the week: transparency. Over the last seven days, my schedule has looked like a patchwork quilt, spanning several distinct sectors of the health care industry. But from the government's roundtable on prior authorization reform to my conversation with Joint Commission CEO Dr. Jonathan Perlin (read on for more on both of those), transparency has emerged as a common thread.Health systems and insurance companies must be transparent with one another; health systems and insurance companies must be transparent with patients. And, of course, health care companies must be transparent with their employees and customers—especially when deploying AI. Monday through Wednesday, many of my colleagues were in sunny Sonoma, California, for Newsweek's cross-industry AI Impact Summit. Senior Reporters Lauren Giella and Katherine Fung kept eyes on the health care side of the agenda, which included speakers from Kaiser Permanente, Hospital for Special Surgery, AdventHealth and UMass Medical."Transparency was a big theme for AI adoption in health care—not only when dealing with medical records and personal data, but also for why and how organizations are implementing automation tools," Giella wrote.Dr. Allen Chang, ACMIO at UMass Medical, warned the audience not to neglect employees' concerns about losing jobs to AI, nodding to last year's strike by the California Nurses Association."A lot of us say that we're not going to be replaced by AI, we want to believe that, but in medicine, we can't just invoke this and expect that to address the underlying drivers as to why people are asking about this," Chang said on Tuesday's health care panel.What could those underlying drivers be? I found some clues in Wolters Kluwer Health's new generative AI readiness report, released at the start of the month. Their survey of health care stakeholders found that 76 percent cite "reducing clinician burnout" as a major priority, and 85 percent say "recruiting/retaining nursing staff" is top of mind.But only 45 percent of nurses responded "yes" when asked if generative AI can reduce clinician burnout. I asked Dr. Peter Bonis, chief medical officer at Wolters Kluwer Health, to help me make sense of that gap—or "disconnect," as he called it."Our survey is indicating that there's an opportunity to work with allied health professionals and clinicians to deeply understand their needs and where some of these technologies can help; to have them on participatory boards as they themselves get educated on what these tools can do; and to select these tools so that they are optimizing their workflows, and they have agency in this process," he said.I've been reporting on a lot of AI-related "disconnects" lately, both within health systems' AI deployment efforts and in external communications with vendors. I asked Bonis: Do these lapses indicate that we're taking the wrong approach to AI deployment in the health care industry? He told me that this isn't exclusive to the health care industry, and that every business is wrestling with the same sort of issues. (Phew.) But, he acknowledged, health care is a high-stakes game, and it's important to deploy AI safely (and transparently) for the benefit of employees, patient care and overall health equity.He believes health systems will succeed if they focus on patient care and bolster that foundation with sound operations and a successful business model."The fusion of those two directives is what creates a future-ready health care system that understands how to use these advanced technologies to advance their operations—to do that thoughtfully—and then to have a coherent pathway to start to use these tools to advance that higher stakes domain," Bonis said, "and that's the journey that we're on."I also spoke with Dr. Perlin, head of the Joint Commission, about that journey to a "coherent" AI pathway. Read on to the Pulse Check section to see what he said.Essential Reading Aiming to improve the prior authorization process, HHS Secretary Robert F. Kennedy, Jr., and CMS Administrator Dr. Mehmet Oz hosted a roundtable of health insurance executives and stakeholders on Monday. Attendees agreed to six reforms: (1) standardizing electronic prior auth submissions, (2) reducing the volume of services that require prior auth, (3) honoring existing approvals during insurance transitions, (4) improving transparency and communication around decisions, (5) implementing real-time approvals for most requests by 2027 and (6) ensuring medical professionals review all denials. These companies were included in the discussion: Aetna, AHIP, Blue Cross Blue Shield Association, CareFirst BlueCross BlueShield, Centene Corporation, The Cigna Group, Elevance Health, GuideWell, Highmark Health, Humana, Kaiser Permanente and UnitedHealthcare. Together, they represent about 75 percent of Americans with commercial or Medicare Advantage plans. The Lown Institute has released its highly anticipated index of America's Most Socially Responsible Hospitals. This year's honor roll comes at a critical time, as hospitals work to maintain equitable care amid potential Medicaid cuts, rising costs and ongoing workforce challenges. Duke Regional Hospital topped this year's acute care ranking, marking its fifth year on the list. Eli Lilly's once-weekly insulin efsitora displayed promising results in Phase 3 clinical trials, reducing A1C and meeting safety standards for adults with Type 2 diabetes, according to detailed datapublished by the company this week. The new drug hopes to simplify diabetes management by reducing the frequency of insulin injections. Diabetes is becoming more prevalent in the United States, affecting nearly 15 percent of adults. By the end of 2025, Eli Lilly plans to submit the drug to global regulatory agencies for the treatment of Type 2 diabetes. Artisight, the NVIDIA-backed health tech company specializing in AI-powered "smart hospital" infrastructure, announced a $40 million investment from a dozen health systems. It's an unprecedented level of support from some of the nation's largest, most forefront integrated systems and academic medical centers. (The list of names was reviewed by Newsweek but is not being released to the public at this time.) Pulse Check If you've been paying attention to the news lately, you may have had the same question that I did: What on earth is going on at the Joint Commission?The independent health care accreditation and certification organization has launched a couple high-profile, high-tech partnerships in recent weeks. First, it announced a long-term relationship with Palantir, intending to use the company's AI platform to streamline accreditation/certification processes. Then, it joined forces with the Coalition for Health AI to establish a "suite" of AI best practices playbooks and a new certification for hospitals. Now, if you work at a hospital, you likely live by the Joint Commission's standards. That's why I called Dr. Jonathan Perlin, president and CEO of The Joint Commission, last Friday. There was a bit of "geeking out about AI," as Perlin put it. But mostly, we discussed the recent CHAI partnership—and what it could mean for quality/safety standards and hospital certifications. Editor's Note: Responses are lightly edited for length and clarity. AI is so different from other components used to assess quality. Each health system uses it in a unique way, and applications vary between hospitals, departments and even patient populations. "Good AI" can be tough to quantify. How do you plan to create a standard with this new certification program? CHAI's lane is really the technology itself, and ours is the organization's governance process for the responsible use of that. You may have seen our Responsible Use of Health Data Certification that has six attributes, and this is really an extension of that. What we anticipate—and this is a work in progress—is that building from the Responsible Use of Health Data [Certification], there'd be requirements for de-identification or privacy that could be data controls for security. There should be some mechanism for transparency with patients. Most importantly, there would be like an oversight or governance structure that addresses the algorithm's or the AI's performance. The notion is that an organization can look to CHAI and to the market to identify an AI tool, but it has to have an active and ongoing governance process to look at the performance of that tool in their environment. To give an example, I think there are three essential components. One is technical: Is [the tool] valid and reliable in a sort of mathematical sense? Second, is it valid and reliable clinically? Does it present the right clinical information? And third, is it valid and reliable in a demographic sense, that you're not applying an AI trained specifically for detection of sepsis in adults to children. To make that clear, if CHAI's lane is really the external performance of the algorithm and the assurance aspects outside of health care, the way we do this [new certification] is not specifically directed at the certification of the AI tool, but the certification of process for the organization's own governance and oversight of the use responsible use of that AI tool. Will this certification assess tools that health systems developed internally, vendor tools that they deploy, or a combination of both? What else will you be looking at within each hospital's AI ecosystem? We anticipate that the certification, which would be given to health care organizations, would be based on the governance structure and the oversight structure I described [above]. We expect it would be applied both to homegrown and off-the-shelf technologies. Our focus is on continuous governance. Let me give an example that's literally closer to home. We just finished a renovation [at my house], and we had an electrical inspection after the work was completed. The wiring of the house is not going to change over time, but the wiring of AI, if it's retrained, if it drifts, etc., may change over time—so the organization needs to have a mechanism for periodic review of the performance of its "electrical system," to use the analogy, not just at inception, but periodically, or frankly, for the life of the use of that technology. Any advice for health systems that are currently building up their AI governance structures, to ensure they're on the right path ahead of the Joint Commission and CHAI's certification? Take a look at our Responsible Use of Health Data Certification, because it really provides insight into the concepts of governance as the regulatory frameworks are emerging. Despite the fact that device drug approvals are static, they are viewing the use of device (good outcomes or bad) as the responsibility of the clinicians and health care organizations that use those. Organizations can independently set up what they think to be best practices for responsible governance and oversight. Having come from operations and large systems myself, it's really important to have a set of externally validated standards that demonstrate what "good" looks like for responsible governance and oversight. I think organizations like ours are hugely excited about the potential, but we want to set up common standards to assure that we realize that potential responsibly. If you liked this sneak peek, remember to check out next week's edition, which will include more of my interview with Perlin. C-Suite Shuffles Joseph Impicciche is retiring as CEO of Ascension, after six years at the helm of the St. Louis-based system. Eduardo Conrado, the health system's current president, will become its new CEO on January 1, 2026. Conrado was named to Ascension's executive team in 2018, after five years on its board of directors. Throughout his tenure, he has also served as the system's chief digital officer and chief strategy and innovation officer. The Medical University of South Carolina (MUSC) has selected Dr. John Marymont as its next provost and executive vice president for academic affairs. Currently, he serves as vice president for medical affairs and dean of the medical college at the University of South Alabama. Lovelace Health System is undergoing its fourth CEO change since 2022, the Albuquerque Journal reported. President and CEO Troy Greer resigned last week after two years in the role. The health system—one of the largest in New Mexico—declined to comment on his exit. Executive Edge Dr. Leigh Vinocur tells me that she considers herself a "lifelong learner." She's spent her career learning different elements of medicine, starting as a urology resident, becoming a board-certified emergency physician and serving as chief medical director for a major health system, overseeing more than 100 providers in the mid-Atlantic region. Now, she is the medical director of a men's health clinic and works part-time in clinical trials at a nutraceutical company. But throughout her working life, Vinocur has also learned a great deal about stress. After leaving her big-box health care role, she dealt with a "corporate medicine hangover." On July 12, she's releasing a book about her journey: Never Let Them See You Sweat: How Science Can Help Us Harness Stress for Success. This week, I connected with Vinocur to learn what her research—and personal experiences—taught her about stress in the health care setting. Here's what she told me: Editor's Note: Responses are lightly edited for length and clarity. "Today, in this political climate, we're seeing changes to health care, erosion of public health. It's making it even more difficult [to work in health care leadership]. There were always issues as a physician, fighting with insurance companies—but as physician executives, it's that kind of double bind that they're in, because they're caregivers, but they're administrators. They have rules they're enforcing, fiscal and institutional constraints, but they have to put their patients first, too. And it's stressful. "Not all stress is always horrible and bad. It gets you to your tiptop performance, you know. Stress was an evolutionary development and advantage to keep us safe. If you were out there being chased by a predator, all those reactions from the hypothalamus, the pituitary, the adrenal release the cascade of hormones for that fight or flight. Whether you're a runner in the Olympics standing in the blocks, or whether you're an ER doctor waiting in the resuscitation room for those accident victims to come in, that little boost of stress gets you at your top performance. It's just this continued stress that is so challenging. "I tell executive leaders that they need some buffer in between meetings. You need to create little micro-breaks during the day that are just for you to calm down. Whether that's meditation (there are apps on our watches and our phones), deep breathing (like box breathing, where you inhale through your nose for four seconds, hold it for four seconds and exhale for four seconds through your mouth), or leadership mentoring (where you have open dialogue and create a safe space to talk about some of the ethical dilemmas you may be facing). "All throughout the book, there are discussions on things you can do in nature, like 'forest bathing.' Study after study says that if you can get to a green space, like a park, that can lower your blood pressure. Just being out in nature, getting outside—you don't even have to exercise—can be a great relief." This is a preview of Access Health—Tap here to get this newsletter delivered straight to your inbox.