
Episode #51
Built Without Us: Physician-Led AI Governance — Dr. Ryan Walsh (CMIO, Memorial Hermann)
Technology keeps getting built for clinicians — and too often without them. This episode of Signal & Symptoms is about closing that gap. Dr. Junaid Kalia is joined by co-hosts Ed Marx, Dr. Harvey Castro, and — now officially on the roster — Dr. Isha Mannering, with guest Dr. Ryan Walsh, Chief Medical Information Officer at Memorial Hermann. Ryan calls his path “the Forrest Gump of health IT”: a family physician and residency educator who raised his hand when someone asked “does anyone know about computers?” and ended up double-board-certified as a “human + machine” leader. The conversation is a working clinician’s field guide to living with AI: what actually excites a CMIO right now, how to de-risk AI so you can use it without getting burned, why residents trust an AI summary inside Epic more than an outside source (and why that’s dangerous), and the med-legal reality that governance and law are being outpaced by the technology. Ed lands the episode’s sharpest line — that the real leading cause of preventable death in a hospital might not be sepsis, but governance that keeps good tools out. Ryan’s answer isn’t to skip the guardrails: it’s a physician-led clinical AI governance council, piloting carefully, and refusing to throw the baby out with the bathwater — “but we do need to test the bathwater.” What You Will Discover: [00:00] Cold open — “nothing is foolproof,” and the EHR-trust trap [00:21] Welcome + meet Dr. Ryan Walsh (CMIO, Memorial Hermann) — Isha joins as co-host [00:57] The “Forrest Gump of health IT” origin story [02:03] What excites a CMIO now: the tech finally catching up [03:23] AI as a thinking partner [04:42] “All technology is deflationary” (Junaid) [05:02] Advice for clinicians: use it, learn the limits, de-risk it [06:29] Do residents trust AI? The EHR-summary surprise [07:43] Fear, soul, and choosing love over 150 years of tech (Ed) [08:13] The bridge: balance, not sides (Isha) [08:42] Med-legal reality + the clinical AI governance council [09:29] “The real leading cause of preventable death? Governance.” [10:07] Don’t throw the baby out with the bathwater — test the bathwater Referenced in the show: ️ Dr. Ryan Walsh — CMIO, Memorial Hermann Health System; family physician + informaticist (“human + machine”) ️ Memorial Hermann’s overarching clinical AI governance council ️ AI summaries inside the EHR (Epic) — and the automation-bias / implicit-trust risk ️ 21st Century Cures Act era of health data + interoperability Connect with us: Dr. Junaid Kalia, Neurocritical Care Specialist and Founder of SaveLife.AI™ (host) LinkedIn — https://www.linkedin.com/in/junaidkaliamd Website — https://www.junaidkalia.com/ YouTube — https://www.youtube.com/@junaidkaliamd Edward Marx, CEO, Advisor (co-host) LinkedIn — https://www.linkedin.com/in/edwardmarx/ Website — https://www.marxadvisory.com/ YouTube — https://www.youtube.com/@EdwardMarx Special Guest: Dr. Ryan Walsh — Chief Medical Information Officer, Memorial Hermann Health System LinkedIn — https://www.linkedin.com/in/ryanwalshmd/ Visit our website: https://signalandsymptoms.com/ Get advisory insights about Healthcare AI — at zero cost: https://junaidkaliamd.substack.com/ Medical disclaimer: This conversation is for general informational purposes and is not medical advice. Listening does not create a doctor–patient relationship. Views expressed are Their own and do not represent the employer. Tools and methods discussed are decision-support and research infrastructure with a clinician in the loop — not autonomous or cleared diagnostic devices. No PHI is shared.

