"If you're not at the table, you're on the menu." This statement from a physician colleague changed Dr. Devjit Roy's career trajectory. Today, as CMO, CMIO, and Vice President of Medical Affairs at Nathan Littauer Hospital, Dr. Roy makes sure clinician voices shape technology decisions. In a conversation on The CereCore Podcast, he shares lessons about optimizing MEDITECH in rural settings, keeping clinicians engaged, and approaching AI with both optimism and caution.
Stream the full episode to hear how this practicing hospitalist balances frontline care with executive leadership.
Editor's note: Conversation highlights below have been edited for clarity and brevity.
When Dr. Roy arrived at Nathan Littauer Hospital, he found a physician population that was disengaged after COVID and a new EMR transition.
"We're just coming out of a pandemic. We had just switched over to a new EMR, and any EMR transition is a lot. Change is a lot," he explained.
The solution wasn't just better systems. It was making clinicians feel seen, heard, and acted upon.
"A doctor's mission is pretty simple. We're trying to help the person in front of us. But we also have families. I was putting in 12 to 16 hours a day. If you sleep eight hours, how much time do you really have left?" Dr. Roy said. "The meaning is what matters to clinicians, but also being seen and heard, and not only heard, but acted upon."
Rural healthcare faces unique challenges: workforce shortages, aging infrastructure, financial pressures, and limited access to specialists.
"We don't always have a specialist on call. We have to figure it out. It's like being MacGyver," Dr. Roy said. "What's tough is even if you identify a patient your system can't manage, you still have to get them somewhere else. What if you don't have an ambulance? What if it's snowing?"
Technology access creates another barrier. Many residencies train physicians using AI tools and robotic surgery platforms rural hospitals can't afford.
"A rural setting ends up getting aged out or teched out. There is a reality of digital health equity. The folks in this region deserve the care," Dr. Roy explained.
"We need to be part of this AI revolution. If we're not, we're just going to repeat the same things we did with EMRs." - Dr. Devjit Roy
Nathan Littauer Hospital implemented MEDITECH Expanse, but implementation is just the beginning. Identifying gaps and optimizing workflows requires continuous effort and external perspective.
"We don't know what we don't know," Dr. Roy said. "While we're trying to optimize an EMR, we've all been in planning meetings that theorize what will help, but it isn't until you're in it that you can tell what's a problem."
Working alongside CIO James Wellman, CereCore helped assess their EHR implementation and create a roadmap for improvement.
"James brought that external view to our organization. He did such an awesome job identifying, 'Yeah, you guys are doing good, but you can be doing better.' That's where it's important to be humble, to be curious, but then have that grit and discipline to stick to it," Dr. Roy said.
Dr. Roy is optimistic about AI's potential to reduce administrative burden but cautious about over-reliance on algorithms that lack human judgment.
"Algorithms should be used as flashlights rather than steering wheels. Tech is great, but we have to slow down," he said.
He shared a sepsis case where an algorithm got it wrong because it couldn't account for subtle clinical signs an experienced physician could detect.
"Algorithms cannot replace human judgment right now. I can look at a person, have a conversation, and tell exactly what is going on. I can read their body language," Dr. Roy explained. "What I love about AI is it keeps getting better, it keeps learning. That will allow clinicians to focus on taking time with the patient, being present. We have to embrace it, teach the AI like it's a medical student."
For Dr. Roy, the right partner delivers three things:
Honesty over hype: "I don't need a sales pitch. I just need what makes sense. Understanding our constraints is big. Our CIO James has uplifted our system to be digitally ready, and that took years."
Accountability and trust: "In a rural setting, it takes us a lot to trust because we've been figuring this out on our own."
Long-term partnership: "I'm all about the relationship. For our frontliners, respecting their realities, making sure the interventions make sense to them."
The impact of behind-the-scenes work
"The impact you guys have on patients is huge. If the patient or clinician doesn't feel it, that means IT did their job," Dr. Roy said. "All of these things add up. At the end of the day it's a person that needs help. We want to be the best part of your worst day. You have no idea how much that's appreciated."
For healthcare leaders caught between tech pressures and people pressures, Dr. Roy offers this:
"I will never regret slowing down optimizing systems or technology if it's going to help the person in front of me. By being humble to the changes, curious to what's going to happen, and staying with grit to do what's right for the person in front of us, you'll never regret slowing down to preserve this humanity in us." - Dr. Devjit Roy
Stream the full episode to hear more from Dr. Devjit Roy about his journey from COVID frontlines to dual leadership, his book Between Heartbeats and Algorithms, and why he believes the future of healthcare depends on keeping physicians at the decision-making table.