For CIOs, one of the most challenging – and increasingly difficult – aspects of the role is the ability to “perform and lead under pressure,” and establish a way forward, according to Christine Yang.

Doing so has never been easy, but for safety net organizations like Alameda Health System that service a large percentage of Medicaid patients, the struggle intensified after the H.R. 1 bill was signed into law last summer. 

“We’re impacted just like so many others,” said Yang, who has been with the organization for 4 years, stepping into the CIO role in August of 2025. “And because we’re a public system, the impact is larger.”

Christine Yang

Fortunately, Alameda has spent the past few years building a foundation that she believes will position them well for success in the future.

“We’ve put the pieces in place through governance and our executive roadmap, and now we’re looking at operational efficiencies and transformation,” she noted. “That’s at the forefront for the whole organization. It’s not about replacing FTEs; it’s about improving efficiency and creating more time for patient care.”

The “Ongoing” AI conversation

Part of that, according to Yang, is keeping up with the latest offerings from Epic, which the organization fortuitously implemented just before Covid-19. “We’re excited about the rapid process Epic is making. That’s been a big accelerator for us,” she noted, adding that she’s particularly excited about the potential for Epic’s CDI nudges to improve documentation. “Physicians are always asking for help there. And so, we’re looking at every opportunity to automate and achieve real measurable impact.”

That’s where AI tools can also play a key role.

For example, ServiceNow’s AI Agents are being utilized to create support tickets, removing some of the administrative burden on already taxed teams. “We get so many inquiries, and users typically want a quick response,” Yang noted. “This helps a lot,” especially for organizations dealing with workforce shortages.

And she doesn’t plan to stop there; the organization is looking to use agentic AI to automate in areas such as finance and HR, along with clinical support tasks. Ideally, advanced analytics will be leveraged to help update EHRs, book appointments, and facilitate patient communication. “There are so many efficiencies that can be gained,” she noted.

One of the key factors in being able to realize those efficiencies is education, particularly when it comes to something as complex as AI. “Everyone has their own definitions – including the board,” said Yang, who has prioritized literacy and encourages open discussions.

“There’s a lot of talk about AI, but what does it mean for our health system? What type of value can it bring? Those are the questions we focus on,” she said, which covers everything from credit scores to how it fits into the roadmap. “I’m happy with the progress we’ve made thus far, and we’ll continue to push forward. This is an ongoing conversation.”

Getting Lean

A key factor in what enables a safety-net organization like Alameda to have these conversations is its strong focus on process improvement, according to Yang. Her team, all of whom are Lean certified, has been tasked with identifying opportunities for improvement, and coming up with solutions that “show a true impact to the organization.”

Where Lean’s influence comes through, she believes, is in true problem-solving. “When we design workflows with our customers, it’s not just about troubleshooting when there’s an incident. It’s stepping back and saying, ‘what’s your workflow?’ And going from there.”

In fact, having not only Yellow and Green Belt-trained individuals, but also a Black Belt-certified leader (Alameda’s Chief Revenue Cycle Officer) has led to significant improvements in terms of escalating critical issues and reducing unnecessary communications. “They can see a difference because they’re solving problems differently,” she said. As a result, “we’re doubling down on process improvement. It’s a challenging time, but it’s also a moment for us to take the lead and make a difference.”

Trust, Clarity & Accountability

The challenges, however, won’t end anytime soon, which is why it’s so critical for leaders to maintain a consistent presence. “People look to us when there is a major situation or critical initiative that changes how we do operations,” Yang stated. “As a leader, I want to be steady. I want to be there for people.”

The way she hopes to achieve that? First, by creating a culture of “trust, clarity, and accountability,” which includes establishing a high-level of communication discipline among both leaders and staff. “I always want to make sure my team can focus, and that only happens when they aren’t getting all of the outside noises. That discipline is so important.”

The second is by mentoring, which she has done through a fellowship with the Carol Emmott Foundation, as well as within Alameda, an organization that “truly walks the talk” when it comes to professional development. 

“We want to make those opportunities visible and real,” she said. “It’s not just words.”