Lowe Leverages Disciplined Approach to Achieve Innovation on a Budget

Raymond Lowe, SVP/CIO at AltaMed Health Services, is navigating a classic safety-net dilemma: rising demand, volatile policy signals, and a mandate to deliver more with less. Serving a largely Medicaid population across Los Angeles and Orange counties, the organization operates as a federally qualified health center (FQHC) with tightly managed margins and a technology budget calibrated to hard operational returns. As policy changes reshape eligibility and reimbursement, Lowe is tightening governance, prioritizing measurable productivity gains, and asking his team to translate AI from experiment to repeatable, validated workflows. “We serve over 500,000 lives, primarily Latino, multi-ethnic, non-English speaking here in Los Angeles and Orange County,” he said, framing the scale and complexity of the enterprise.

A Lean Operating Model at Scale

AltaMed’s payer mix leaves little cushion for discretionary investments, and that constraint anchors the information services strategy. Lowe pegs the organization’s IT spend at roughly 2.8% of revenue—below the 3.5%–4% he sees at many peer institutions. “We came in around 2.8%, which is very skinny,” he said, noting the run state must still support an Epic EHR, Workday, enterprise networks, cybersecurity, and analytics. That lean posture becomes more consequential as California’s coverage dynamics evolve and federal reimbursement models shift toward managed-care rates over the next several years. Internally, the planning premise is that every new technology must either generate revenue or create quantifiable efficiency. That discipline has not kept AltaMed from pursuing modernization; it has forced a narrower aperture. The portfolio favors platforms the organization already owns, optimization over net-new tools, and projects with clear paths to scale—particularly those that shrink documentation time, accelerate patient access, and automate routine back-office tasks.



Ambient Scribing, Measured ROI

One example is ambient clinical documentation. After going live in late spring with an ambient listening vendor, adoption quickly exceeded expectations. Across roughly 400 providers, more than 280 requested access, and early data show an average gain of about 20 minutes per physician per day in reduced “pajama time.” Lowe’s team is quantifying impact with Epic Signal and other workflow telemetry, pairing that with informatics-led coaching to raise utilization and consistency. The next milestone he’s targeting is order-entry assistance, a change he believes can drive another step-function in productivity once it is validated for safety and reliability. The approach illustrates his philosophy: don’t pilot forever, don’t scale prematurely. Set thresholds for efficacy, stop experiments that stall, and redeploy capacity to what demonstrably moves the needle. He calls this ethic “execution as innovation,” and the results—such as AltaMed’s standing as a 10 Gold Stars organization in Epic and a top-tier utilization ranking—suggest the formula can deliver material gains without expanding the spend envelope.

AI Governance With Guardrails

Lowe has formalized AI oversight with an executive steering committee co-chaired with legal counsel. The committee’s scope ranges from policy and risk to testing protocols and vendor posture. Before opening the door to generative tools, the organization inventoried and restricted unsanctioned AI domains, then stood up a safe environment for internal experimentation to reduce data-leakage risk. On the security stack, the roadmap is to push beyond alerting into autonomous response where appropriate—using extended detection and response platforms to identify threats, recommend fixes, and execute them under human supervision. The standard for introducing AI into operations is rigorous: controlled pilots, model validation, and clear metrics for accuracy, bias, and downstream workflow effects.