Providence’s Goswami Prioritizing Spending Time on the Front Lines & Staying Focused on the Patient

Chero Goswami discusses how Providence uses a relationship-first philosophy and front-line rounding to ensure innovation drives real patient impact.

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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.

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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. Goswami views redundancy and resiliency as expectations with significant capital costs, made harder by concentration in cloud infrastructure. Recent incidents at major cloud providers, he observed, bring home the limits of single-vendor dependencies and the importance of thoughtful diversification. He balances “just in case” investments with “just in time” options, prioritizing the scenarios that most affect clinical operations while acknowledging that perfect coverage is financially unrealistic.

The centerpiece of Goswami’s approach is a refreshed business-continuity program that reflects today’s risks. He points out that many downtime plans were built for planned maintenance windows, not multi-day cyber events or prolonged outages in critical scheduling and documentation tools. Goswami is partnering closely with Providence’s chief operating officer to ensure front line leaders own the playbooks and training.

In his view, technology and security teams should focus on recovery and risk thresholds, but operations must carry the largest share of continuity execution — from staffing plans and alternative documentation methods to rehearsed procedures that keep care moving. He also highlights a “three-legged” leadership structure: the CISO and infrastructure leaders drive technical recovery, the chief risk officer guides what is safe to attempt, and the COO convenes and equips clinical and operational teams to deliver care under stress.

Goswami is candid about the workforce reality: a generation of caregivers has never practiced on paper, so electronic failover — not reversion to manual workflows — should be the default. That requires tested runbooks, cross-training, and simplified, standardized contingencies that can be activated quickly. The goal, he argues, is not only higher uptime but predictable continuity when the inevitable happens.

Take it Away

• Tie any fix to the patient in “three hops or less,” so teams maintain focus on outcomes rather than tools
• Understand product, practice, and performance variations; standardize the combinations that measurably improve results
• Build governance that decides what to pursue and what to defer; pair it with an operating model that assigns ownership and timing
• Design patient and family experiences with plain language, minimal steps, and clear status feedback
• Shift downtime planning from maintenance windows to multi-day cyber scenarios; rehearse electronic failover
• Diversify critical vendors where it meaningfully reduces risk and cost allows; avoid creating fragile single points of failure
• Round regularly with clinical teams to validate assumptions, surface “small” reliability issues, and close the loop through standard processes
• Pair the CISO, CRO and COO roles so technical recovery, risk guidance and operational execution are coordinated and accountable

Asked his advice for others who might have a little fear about stepping into larger roles, Goswami – who started at Providence, one of the largest health systems in the country, less than a year ago – said a little fear is ok, and the mission is well worth it, adding “healthcare is a calling.”