Governance & Close Coordination with Users Keys to Ensuring AI Infusions Into Imaging Workflows Help Rather than Hinder

Dr. Elias Kikano, Medical Director of Imaging Informatics at Grady Health System, shares strategies for fostering effective collaboration between CIOs and clinical imaging leaders to advance AI and enterprise imaging initiatives.

As healthcare organizations face accelerating demands to integrate AI and consolidate imaging operations, the relationship between enterprise IT executives and department-level imaging informatics leaders has never been more critical. At Grady Health System, Dr. Elias Kikano, Medical Director of Imaging Informatics and Assistant Professor at Emory University, offers valuable insights into how positive collaborations can drive strategic success.

“Imaging is one of the most fertile areas for AI deployment,” Kikano said, noting that over 90% of FDA-approved AI tools in healthcare are in imaging. Yet successful deployment demands rigorous clinical validation, operational diligence, and, importantly, alignment between enterprise IT leaders and departmental experts.

Building Collaborative Partnerships

Kikano emphasized that enterprise CIOs seeking to advance imaging modernization should start by partnering with clinicians who have formal training or deep expertise in imaging informatics. “You need someone who can bridge both camps—clinical practice and IT infrastructure,” he said. Leaders like Kikano, who understand both sides, are essential allies for CIOs aiming to navigate complex technical deployments without disrupting clinical workflows.

He advised that CIOs actively engage imaging informatics professionals early in project planning, particularly when evaluating AI tools or enterprise imaging strategies. “Having operational leaders actively participate ensures that new technologies truly support, rather than disrupt, care delivery,” Kikano said.

The engagement should extend to governance structures. At Grady and Emory, multidisciplinary AI governance councils bring together clinicians, IT, legal, finance, and analytics teams. “You have to bring all the expertise together,” Kikano emphasized. “Otherwise, you risk either making hasty decisions or getting paralyzed by bureaucracy.”



Beyond planning and governance, Kikano emphasized the importance of regular, open communication. “Periodic check-ins between IT leadership and clinical informatics teams can uncover issues before they escalate and ensure projects stay aligned with clinical needs,” he said.

Strategic Alignment and Practical Validation

Kikano stressed that collaboration must be rooted in shared strategic priorities. “When leadership commits to staying on the cutting edge, governance can focus not on whether to adopt new tools, but on how to do so safely and efficiently,” he said.

CIOs and imaging informatics professionals must work together to validate AI tools against the local patient population—a process Kikano called “crucial.” AI models trained elsewhere may not perform adequately in every clinical environment. “Without local validation, tools that perform well elsewhere might underperform in our environment,” he explained.

Enterprise IT leaders can also support department-level imaging professionals by addressing operational realities. “Predictive analytics can help balance patient loads and identify equipment needs,” Kikano noted. Such efforts directly impact clinical efficiency, offering tangible benefits that resonate with frontline staff.

Importantly, Kikano warned that governance councils must be action-oriented. “Voting structures, clear timelines, executive sponsorship—these elements are critical to prevent endless discussion loops and to drive real progress,” he said. CIOs play a key role in ensuring governance processes are streamlined and goal-driven.

Another aspect of strategic alignment involves education.