Chero Goswami, Chief Information & Digital Officer, Providence, is using front line observation, disciplined governance and renewed business-continuity planning to align technology with clinical reality across the seven-state system. In a recent interview, he outlined an approach that favors standard methods where possible, local flexibility where required, and a culture that treats reliability as a clinical imperative.

Goswami emphasizes learning healthcare by “walking the floors,” listening to clinicians and patients before prescribing fixes. He encourages leaders and staff to shadow units, using those sessions to validate how tools are understood and where they fall short. Goswami frames this as a habit rather than a mandate, noting that observations gleaned on rounds often save “50 emails a week” and surface issues that never make it to dashboards or meetings.

On why in-person context matters, he explained: “Work is practiced on the front lines, so how can we understand the value of our work (in IT) if we don’t know how the work is going to be consumed?” That perspective extends to humble problems—like a broken printer—that cause outsized disruption to discharge timing and patient flow. He argues leaders should respond empathetically while still routing fixes through standard processes so ad-hoc “workarounds by title” do not undermine reliability.

Designing for Patients’ Real Needs

Patient-facing technology, he says, should be built with human-centered design, written in plain language, and sensitive to the moments when people are most vulnerable. Goswami cautions that families and patients consume information differently and that systems must present data without overwhelming users. “You have to design the systems in a way that the layperson can understand it,” he said. Goswami also stresses the indirect patient impacts of IT reliability: when a cafeteria register fails during the lunch rush, for example, the line grows, breaks run long, and bedside coverage can thin — creating the risk for small outages to impact clinicians whose time is always at a premium.



Goswami links design choices to system-level outcomes. He urges teams to trace any proposed technology or fix back to the patient within “three hops or less.” That discipline, he argues, shifts conversations from tools to solutions and nudges teams to measure what matters. He adds that modern constraints—crowding in emergency departments and staffing pressures—require workflows and technology to coevolve, not simply graft new tools onto old processes.

Governance, Operating Model and Variations

Enterprise-level governance, Goswami notes, must clarify both what the organization will do and what it won’t. “A true ‘no’ is much better than a fake ‘yes,’” arguing that demand will always exceed capacity and that transparent choices build trust. He is standing up a two-tier structure: system-wide decisions for common processes and platforms, paired with regional governance to honor local regulations and population needs. Governance, he adds, is incomplete without an operating model that assigns ownership, timing and execution methods.

Goswami also separates three kinds of variation that complicate the EHR and its ecosystem: product variation (multiple tools doing the same job), practice variation (different ways of performing the work, sometimes for valid reasons), and performance variation (measurable differences in results). He encourages leaders to examine each type, then elevate the combinations that demonstrably improve outcomes to become the new standard. The corollary is that technology adoption often requires workflow redesign. Goswami cites a guiding maxim he keeps close: swapping modern tools into legacy methods tends to produce a more expensive version of the past unless processes are re-engineered to fit.

Resilience and Business Continuity

System availability remains a constant focus.