If You’re Running AI Strategy at a Health System, This Is Your Briefing.
I’m Paul Swider, Chief AI Officer at RealActivity, where we build mission-critical AI that gives clinicians hours back in their day and keeps health systems compliant with HSS and CMS.
For 30 years, I’ve been deploying AI in live clinical environments, not theorizing about it. From building one of the first AI triage engines for same-day surgery in 2001, to launching Wheelhouse Frontier (the first model fine-tuned on PeopleSoft operations and executive prompt data), every system I’ve shipped starts with one question: Does this give time back to clinicians?
If the answer isn’t yes, we don’t build it.
Why This Newsletter Exists
Healthcare AI is flooded with hype from people who’ve never survived a go-live weekend. This newsletter cuts through it.
I write for CMOs, CMIOs, CTOs, and senior leaders who are making real decisions about AI adoption—not chasing demos. Every issue draws from actual deployments across major health systems, including HIPAA cloud migrations, CMS compliance platforms, clinical workflow automation, and AI governance frameworks that hold up under scrutiny.
What You’ll Get
Implementation intelligence, not theory. Playbooks from real hospital deployments, the engineering decisions, governance trade-offs, and lessons that never make it into vendor pitches.
Microsoft ecosystem depth. As a Microsoft MVP and Azure Most Influential, I cover what matters in the Microsoft healthcare stack — from Copilot integration to Azure AI architecture, with the technical credibility to separate signal from noise.
Global perspective. I’ve spoken on every continent, founded the Boston Healthcare Cloud & AI Community (BOSHUG), and connected innovators across 50+ countries. The best ideas aren’t limited to one market.
Ethical AI that works in production. Not governance theater — real frameworks for deploying AI responsibly in clinical settings, shaped by co-founding the Wheelhouse AI Center of Excellence.
Executive strategy without the vendor BS. Honest analysis of what’s working, what’s failing, and what healthcare leaders actually need to know right now.
The Track Record
This isn’t a side project. It’s backed by three decades of building:
AI systems from symbolic triage engines to frontier models trained on clinical operations data
3,000+ engineers trained in enterprise healthcare software patterns (GE, IDX, Microsoft)
50+ HIPAA workloads migrated to Azure
CMS compliance platforms and medication safety systems are still in production
Microsoft MVP & Azure Most Influential recognition
Microsoft Startups Level 4 graduate — currently in growth phase
Top 3% global speaker Microsoft Ignite, Cloud Wars, and healthcare conferences worldwide
Who Reads This
Healthcare Executives making real AI investment decisions who need someone who’s actually deployed these systems to tell them what works.
Clinical Informatics Leaders evaluating AI tools who want technical depth without the sales pitch.
Health IT Architects building the infrastructure for clinical AI who need proven patterns, not PowerPoint promises.
The Mission
Use AI to care for those who care for others.
Technology should serve clinicians, not burden them. Every tool we build, every insight I share here, is in service of that principle.
Let’s Work Together
If your health system is navigating AI adoption and you need a partner who’s done it before, not a consultant selling the next engagement, I’d like to hear from you.
📩 Reach out directly: Connect with me on LinkedIn 🌐 Learn about RealActivity: realactivity.ai
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