Insights by Linda Stevenson, Chief Operations & Information Officer, Fisher-Titus Health
Key Points
- Rural health innovation is an execution discipline: partnerships, workflow optimization, and outcome focus matter more than shiny tools.
- AI is “just another tool” within a larger strategy, and leaders should start with the problem before deciding whether AI fits.
- Interoperability and cybersecurity remain the biggest constraints in rural areas, and rural vulnerabilities weaken the entire healthcare chain.
“We’re a hundred-bed rural hospital, so we do more with less.”
That’s the context Linda Stevenson brings to this episode, and it changes the entire tone of the conversation. Fisher-Titus Health is a community-based system in Norwalk, Ohio that spans care across the full patient lifecycle, from birth to end-of-life care, including physician practices, home health, skilled nursing, and nursing home services. And as of March, Stevenson’s role expanded beyond CIO responsibilities to include COO oversight of ancillary services, facilities, and environmental services.
Her story is also a reminder that healthcare technology leadership doesn’t require a linear path. She started typing bills on a typewriter, moved into analyst work because she was always asking “why,” then progressed through project management, security, and major EHR implementations, including an early Epic rollout at Cleveland Clinic and vendor-side experience at Cerner (now Oracle Health). Her advice is simple. Say yes, even when you’re unsure. That “jump in the pool” mindset is also how she took on the COO role.
But the most important part of this episode is not her resume. It’s her operating philosophy for rural health systems: stay grounded in enterprise strategy, focus on real outcomes, and resist the temptation to treat AI as a standalone strategy.
Listen to the full conversation
Rural innovation is partnership plus pragmatism, not a single priority
When asked what a CIO should prioritize today, Linda answers with the only honest response, “all of it.”
Innovation, cost control, operational reliability, productivity, clinician experience, and patient access all compete for attention. And in a rural system with constrained budgets and staffing shortages, those trade-offs quickly become real issues.
Her way of navigating that complexity is partnership.
She repeatedly returns to the need to partner with nursing leaders, finance leaders, operations leaders, and clinical stakeholders to identify the real constraints and the real opportunities. In some areas, the problem is recruitment. She points to therapy departments that cannot find enough therapists. The strategy isn’t to cut staff. It’s to use technology to help the available staff work faster without sacrificing quality, so more patients can be seen.
In other areas, the problem is cost. Linda points toward application rationalization and optimization, using what you already pay for more effectively, consolidating where you can, and getting the best value for each dollar spent.
And sometimes the ROI is human. She highlights automation and workflow improvements not only for productivity but also to reduce daily stress and burnout for staff and to improve patient access.
The underlying point is a rural reality: you don’t get to pursue innovation as a separate track. Everything has to map back to outcomes. Everything has to be anchored in what the organization can operationalize with limited people and limited dollars.
“I don’t have an AI strategy. I have a strategy”
Linda has been in healthcare long enough to see buzzwords come and go. She remembers cloud hype, early EHR hype, and other “next big things” that were positioned as the answer to everything.
That’s why her framing of AI is so grounded.
When people started asking about “AI strategy” two years ago, her reaction was simple. AI is another tool. It might be more impactful than some past shifts, but it still needs to align with the organization’s enterprise and technology strategies.
Her overarching philosophy is one rural health leaders will recognize immediately: “the goal is not to chase shiny objects. The goal is to solve problems.”
This is why her adoption model starts with a practical sequence:
- Partner with leaders in each area to identify the problem.
- Define the outcome you want, i.e.: productivity, cost savings, time savings, quality improvements, or patient satisfaction.
- Then determine whether AI is the right tool, or whether another approach solves the problem better.
She also addresses what keeps teams aligned, “explaining the why.”
Many vendors will pitch a shiny solution, and some of those will become strong partners. But not all. Linda emphasizes that leaders need to understand why certain products fit and others don’t, especially because rural systems don’t want 30 different tools solving a single category of problems.
Once stakeholders understand the reasoning, they’re often open to pursuing an integrated path rather than chasing every new option.
This is also where her perspective is quietly strategic: she’s not anti-AI. She’s anti-randomness. She wants AI used where it improves outcomes and operations, not where it creates more complexity.
Interoperability and cybersecurity are rural health’s biggest constraints
Few topics reveal the rural challenge more clearly than interoperability.
Linda notes that interoperability has been discussed for years, but even when systems are technically “connected,” the information does not always flow in a way clinicians can use. That’s the real gap. Not whether data can move, but whether it arrives in a usable, workflow-friendly format.
This problem is amplified in rural settings because rural hospitals rarely have a closed ecosystem of specialists. They refer out. They coordinate across organizations. They need continuity of care across walls.
She gives a vivid example, explaining to host Ritu M. Uberoy, how maternity records still don’t flow cleanly through standard interoperability formats. In some cases, systems still fax papers back and forth with outside OB physicians. That reality undercuts the “interoperability solved” narrative and reinforces how much work remains in real-world care coordination.
She also points to a pathway rural leaders can use to influence improvement and engagement at the state level. Linda serves on the board of Ohio’s HIE and praises the state’s progress, not only for CCDAs but for broader population health initiatives and Medicaid support. Her argument is that rural systems cannot solve interoperability alone. They need collective coordination through state infrastructure and policy.
Cybersecurity is the other constraint she highlights, and her perspective comes with unusual credibility. She testified at the Senate HELP Committee on rural healthcare and cybersecurity risk. Her message is straightforward: rural systems have smaller budgets, smaller teams, and fewer cybersecurity professionals available to recruit. That makes it harder to keep up with constant attacks and harder to manage third-party risk.
But her most important point is structural: rural systems are links in a chain. Many organizations connect through them, directly or indirectly. If a rural link is weak, the broader healthcare chain is weak.
That framing should matter to every leader, not only rural CIOs. Cyber resilience is not isolated. It is ecosystem-level.
Take a breath, stay strategy-driven, and don’t buy a million shiny objects
Linda closes with advice that feels especially relevant right now. AI is moving fast. Costs are changing. Vendor promises are everywhere. The pace can create pressure to rush, to buy, to “do something” just to keep up.
Her guidance is to take a deep breath.
Think it through. Stick to strategy. Don’t rush into a million shiny objects. Focus on where technology truly benefits outcomes. And don’t forget the human dimension, including your own well-being. When leaders run at this pace nonstop, health systems lose clarity and teams burn out.
Her message is a “rural health reality check” with broader relevance. To Linda, the organizations that win won’t be the ones that adopt the most tools. They’ll be the ones that align technology to enterprise priorities, build partnerships that scale, and strengthen interoperability and cybersecurity so care can extend beyond walls without breaking.
The Takeaway
Linda Stevenson’s message is refreshingly grounded. Rural health systems don’t need an “AI strategy,” they need a strategy, with AI used only when it clearly advances outcomes. In a 100-bed hospital with a lean IT team, innovation is less about building new tools and more about partnership, workflow optimization, and disciplined choices that reduce complexity instead of expanding it. The leaders who succeed in this environment will be the ones who stay “strategy-driven,” resist shiny object overload, and build trusted partnerships that help them do more with less while still delivering the quality and continuity their communities depend on.
Sitting at the intersection of rural operations, enterprise technology leadership, and ecosystem-level cybersecurity advocacy, Linda Stevenson’s unique insights are especially valuable:
- Rural innovation requires practical partnership across leaders to improve outcomes with limited resources.
- Start with the problem, then decide if AI fits; AI is a tool, not a standalone strategy.
- Workforce shortages make productivity tooling essential, not optional, especially in therapy and clinical support areas.
- Interoperability still fails in real workflows, and rural care coordination magnifies the pain of gaps.
- Rural cyber vulnerabilities weaken the entire healthcare chain, making resilience an ecosystem issue.
- The best advice in a high-velocity market is to stay disciplined: take a breath, stay aligned with strategy, and avoid shiny-object overload.