POV - Alessio Morley-Fletcher - Shaping Responsible AI in Pediatrics, Culture and Trust Outweigh Code

Dr. Morley-Fletcher is an HLTH Thought Leader and pediatric hospitalist at Boston Children’s Hospital, where he co-chairs the Department of Pediatrics’ Effective AI Committee and co-leads Physician Wellness across the BCH Network, including South Shore Hospital, where he also directs Pediatric Simulation. A passionate clinician-innovator, he champions responsible AI adoption, clinician wellbeing, and patient-centered innovation.

Based on your experience at Boston Children’s Hospital, how is AI being adopted and integrated into clinical practice?
At Boston Children’s, AI adoption is deliberate, responsible, and guided by leadership vision. Under the direction of our CIO, John Brownstein, and the Innovation & Digital Health Accelerator (IDHA) team, we are embedding AI in ways that directly improve efficiency, safety, and clinical decision-making while minimizing disruption. For example, pilots are underway to support clinical documentation, surface relevant information in the EHR, assist in imaging interpretation and many other very exciting initiatives. The guiding principle is that AI should feel like an invisible assistive layer within the clinician’s workflow, not an added burden. This measured, responsible approach ensures that AI adoption advances patient care while maintaining clinician trust.

Do you think cultural factors pose a significant barrier to AI adoption in clinical practice? If so, how can they be addressed?
Cultural factors are often more challenging than technical ones. Clinicians are trained to be skeptical, and that caution is appropriate. Their responsibility is to patients, not to new tools. At Boston Children’s, our Chief of Pediatrics, Wendy Chung, recognized this and created the Department’s Effective AI Committee, which I am honored to co-chair. The Committee is specifically charged with ensuring that cultural concerns, such as transparency, trust, and clinician involvement, are addressed from the start. We strongly believe that when piloting AI-driven solutions, front-line providers should be included in design and testing, allowing them to shape guardrails and workflow integration. This co-design approach is essential in building trust and ensuring that AI adoption is not only trusted but truly effective in improving care.

Could a hybrid role help clinicians balance clinical practice with technology roles to address burnout? Additionally, could this enhance both the quality and cultural acceptance of technology solutions in practice?
Hybrid roles are critical for the future of clinical AI. Allowing clinicians to divide their time between patient care and technology development reduces burnout by giving them agency in shaping the tools they will ultimately use. What makes Boston Children's such a special place is that it embodies this hybrid approach, pairing clinicians with technical teams. This not only improves the quality of solutions but also accelerates cultural acceptance, since clinicians are more likely to adopt tools designed by their peers. By supporting these roles, our institution is creating a model where technology innovation is clinically grounded, culturally sensitive, and sustainable.

What role do forums like HLTH play in advancing responsible innovation in health systems and hospitals?
HLTH provides a unique platform for health system leaders, clinicians, and innovators to come together in an open, forward-looking way. It’s not just about showcasing technology, it’s about building the relationships and shared understanding necessary for meaningful, scalable adoption. I am honored to serve as a Thought Leader for the HLTH Health Systems & Hospital Innovation community, which has created a space for hospital executives, clinical leaders, and technologists to learn from one another and share practical strategies. By fostering dialogue across institutions, HLTH helps ensure that innovation is not only exciting, but also responsible, inclusive, and impactful for patients and providers alike.

Do you think AI is enhancing patient empowerment in their own care? If so, how?
Yes, AI can empower patients by making information more transparent and personalized. In pediatrics, families often face complex medical terminology and uncertainty. AI tools can help translate clinical data into accessible language, create personalized educational materials, and even provide anticipatory guidance based on an individual patient’s condition. We have seen that when parents are better informed, they come to visits more prepared, more confident, and more active in shared decision-making. Importantly, this does not replace the provider–patient relationship, it strengthens it by enabling conversations that are more focused and meaningful.

You recently won the Harvard Health Systems Innovation Lab’s global hackathon on AI in healthcare. How does that experience connect to your work at Boston Children’s and your role with HLTH?
The HSIL hackathon was an incredible opportunity to think boldly about how AI can address real-world health system challenges, in collaboration with colleagues from around the world. For me, winning that competition reinforced that clinicians’ insights from the bedside are essential in shaping impactful solutions. It perfectly aligns with our mission at Boston Children’s to pursue AI responsibly and effectively and also connects with my role at HLTH and in promoting rich and thought-provoking discussions in healthcare. These experiences collectively highlight that when clinicians are empowered, they can help lead innovation that is both globally relevant and locally impactful.

You recently launched the initiative White Coats, Bold Moves: The Entrepreneurial Clinician’s Playbook at HLTH USA in Vegas. Could you share why this initiative is important and what impact it will have moving forward?
Clinicians bring unique insights from the bedside that are critical to shaping meaningful innovation. With our session at HLTH USA in Las Vegas, I wanted to explore how frontline clinicians can turn insights into bold, sustainable solutions. By embracing an entrepreneurial mindset, we can not only implement AI responsibly but also help ensure that innovation remains grounded in patient care. I was joined by great co-panelists, equally passionate about empowering clinicians and patients. Our session was incredibly well received, and we quickly ran out of seats, showing just how eager fellow clinicians are to contribute to healthcare innovation. With the many participants, we shared experiences on merging clinical expertise with entrepreneurial thinking, demonstrating that meaningful, clinician-led innovation often starts at the bedside and spreads across the healthcare system.

I feel that from startup launches to system redesigns, clinician innovators are finally empowered to show that meaningful change often starts from within. Our kick-off at HLTH USA in Las Vegas was just the beginning of building a community where bold clinician-led innovation can be celebrated, supported, and scaled.