Designing the future of care: Advancing an AI-enabled hospital system

HN Summary

• William Osler Health System is embedding AI into its new Epic hospital information system to enhance clinical decision-making, improve patient safety, and streamline care ahead of its 2026 launch.

• The initiative is clinician-led and grounded in strong governance, ensuring AI supports care delivery while maintaining privacy, ethics, and human oversight. 

• By integrating AI into everyday workflows, Osler aims to reduce administrative burden, improve coordination, and deliver more efficient, patient-centred care.

As artificial intelligence (AI) becomes more embedded in everyday use in health care, hospitals across Canada are adopting these tools, supported by strong safeguards and oversight, to improve patient outcomes, support clinical decision-making and improve care across the system. For William Osler Health System (Osler), that work is accelerating ahead of a major milestone: in fall 2026, the organization will become one of the first hospital systems in Ontario to redesign its workflows with AI embedded as it implements the Epic electronic medical record as its new hospital information system (HIS). This marks an important milestone in Osler’s clinical modernization story, enabled by the responsible and strategic use of digital tools.  

“Epic is widely recognized as a global leader in the electronic health record and HIS space, with a digital platform that truly reflects high quality, safe, modern clinical practice,” said David Stankiewicz, Vice President, Digital Transformation, and Chief Information and Privacy Officer, William Osler Health System. “Leveraging its AI capabilities as we design our clinical workflows is a game-changing approach that will assist clinicians with real-time decision-making, enhance quality of care and patient safety, streamline workflows, and boost patient and family engagement.” 

With its new HIS system, Osler has a unique opportunity to explore and integrate AI capabilities during the planning and design process, rather than retrofitting them later. This approach enables teams to thoughtfully assess where AI can add value and configure the system to align with Osler’s clinical environments, operational needs, and the diverse communities it serves. This supports innovation while maintaining a strong focus on safety, ethical use of AI, privacy and security protections, and people-centred care.

“First and foremost, we have invested time in getting the fundamentals right prior to HIS implementation,” said Sharon MacSween, Associate Vice President, Health Information System, William Osler Health System. “This includes focusing on our people, processes and standards at Osler to support safe, effective and responsible use of AI, as well as on the planning, training and governance practices that underpin a major clinical transformation.” 

To ensure patients can feel confident in how their care is delivered, Osler has taken a thoughtful, safety-first approach to introducing AI. Osler developed guiding principles to ensure that AI is used transparently, responsibly and always aligned with people-centred care. Osler also embedded clinical, digital, privacy and quality oversight into its decision-making around the use of AI tools, including specific AI frameworks and proposed legislation that are shaping the regulatory climate for best practice use. Importantly, AI-enabled tools within Epic do not make decisions on their own. Care decisions will always rest with clinicians, with AI functioning as an added layer of support to inform judgement rather than replace it. Data quality has also been a critical focus – AI systems rely on structured data, so Osler has proactively prioritized standardized documentation across care settings. This includes capturing more accurate information related to a patient’s name, gender, language, and social drivers of health, to help reveal inequities and better recognize patterns of need across patient populations.

The transition to Epic and its integrated suite of AI-enabled tools is a substantial change for clinicians across the health system’s five sites, all focused on enhancing patient care and experience. As a result, the HIS renewal has been intentionally designed as a clinician-led initiative, supported by digital and information systems teams ensuring safe, seamless and people-centred implementation.

More than 700 frontline staff, physicians, and managers participated in extensive workflow redesign sessions to examine how care is delivered and how Epic’s AI-enabled features could be integrated into real-world practice and enhance patient care.

“Through targeted work groups, clinicians looked at opportunities to leverage generative and predictive AI tools within specific workflows to boost operational efficiencies, inform decision-making, enhance patient safety, reduce burden, and streamline care coordination, among other benefits,” said MacSween. “Our application teams are now configuring the system to align with clinician decisions regarding those tools.”

In practice, this means AI-enabled tools will be embedded directly into select workflows to surface relevant information at the point of care – such as highlighting potential risks earlier, supporting clinical prioritization, or streamlining routine documentation tasks. For example, in the Emergency Department, Epic with AI-enabled will help clinicians quickly identify key patient information, flag potential risks, and prioritize care. This supports faster decisions, smoother handoffs between care teams, and clearer communication. Patients spend less time waiting, repeat their health history less often, and feel more confident that their care is timely and well-coordinated. 

To support a safe transition at launch, Osler is taking a phased, people-centred approach focused on readiness, training, and on-site support.

“We have a comprehensive change management strategy in place that includes ensuring Osler teams all understand why and how AI-enabled tools within Epic will be used to enhance clinical workflows,” said Stankiewicz. “This will be followed by role-based training and education to ensure staff and physicians learn what is most relevant to their practice and how the enhanced workflows will further support safe, efficient, high-quality care.” 

Following its Epic go-live, Osler will closely monitor key clinical, safety, and operational indicators using built-in reporting and strong clinical oversight. This information will help teams stabilize the system, make ongoing improvements, and thoughtfully introduce additional AI-enabled capabilities over time, with patient safety and quality of care guiding each step.

“This clinical transformation is a cornerstone of Osler’s 2024-2029 Strategic Plan, and it will enable us to deliver even greater value to patients, families, learners and health system partners,” said Dr. Frank Martino, President and CEO, William Osler Health System. “We will be able to plan and respond more effectively to the needs of our communities, free up more time for people-centred care, provide higher-quality data for our researchers to advance clinical innovation, and enable learners at our hospitals to leverage the latest in technologies to support safe, high-quality care.”

Osler’s new HIS is slated to go live on October 3, 2026.