The Problem
How AI got into your practice before anyone decided it should, and what that is costing the people closest to the work.
A new book by Renee C. Portee · Coming soon on Amazon
Before You
Trust It
The Decisions That Protect Patients, Clinicians, and Organizations
AI is here. Trust is optional. Decisions are not. A practical governance playbook for healthcare and dental leaders who are already living with AI, whether anyone approved it or not.
The premise
“Upstream gaps create downstream costs that always land on the people closest to the work or the patient.”
AI is already inside your practice. It is in the scheduling tool, the note-taking assistant, the billing platform, and the vendor update nobody announced. This book is about the decisions that have to happen before you trust any of it: who approves it, who watches it, what happens when it is wrong, and whether you can prove it later.
Written for
Healthcare leaders
You own the outcome, even when you did not pick the tool.
Dental practice owners
Your front desk is already using AI. Here is how to govern it without slowing the practice down.
Clinical leaders and compliance officers
You need decisions you can defend to a patient, a board, or an auditor.
The framework
The Fifteen Pillars
Two tiers. Fifteen decisions. One standard that holds them all together.
Chapter 4 gives you a 15-question scorecard, one question per pillar. The appendix holds the full 45-question Fifteen Pillars Assessment.
Tier OneBringing AI In
Pillars 01 to 0601
Current State
Know the process, who owns it, and who watches it before AI touches it.
02
Staff Voice
Consult the people doing the work before you change it.
03
Patient Impact
Name who feels it when the AI gets it wrong.
04
Preplanning
Decide the hard things before the vendor contract is signed.
05
Rollout Discipline
Go live on purpose, in stages, with a way back.
06
Training Cadence
Training is a rhythm, not a launch-day event.
Tier TwoGoverning AI Once It’s In
Pillars 07 to 1507
Authorization
Who is allowed to let AI act, and who signs.
08
Human Authority
A person decides. The AI never gets the last word.
09
Escalation
What happens the moment the AI is wrong.
10
Monitoring & Alerts
Who is watching, and what tells them something changed.
11
Ongoing Review
Approval is not forever. Review it on a schedule.
12
Audit Trail & Proof
Whether you can prove what happened later.
13
Integration
What the AI is wired into, and with whose keys.
14
Data Handling
Where patient data goes when it leaves the room.
15
Regulatory Alignment
HIPAA, state board, and what changed this quarter.
The SOP Standard
In writing. Owned. Reviewed. One standard governs all fifteen pillars, because a decision nobody wrote down is a decision nobody can defend.
Inside the book
Four parts. Seventeen chapters. Built to be used, not shelved.
Bringing AI In
The Fifteen Pillars, then current state, staff voice, patient impact, preplanning, rollout, and training.
Governing AI Once It’s In
Who decides. When AI is wrong. Can you prove it. Where it reaches. Staying aligned.
The Leadership
The two faces of leadership avoidance, building trust through transparency, and the Regynyx™ framework.
Also inside
- From the Floor interludes: stories from inside the work
- A 15-question scorecard, one question per pillar
- The full 45-question Fifteen Pillars Assessment
- A bonus prompt pack, one prompt for every pillar
About the author
Renee C. Portee
Founder & CEO, Lotus AI Innovation LLC · Chief AI Governance Officer, Regynyx™ · CPD-Accredited AI Consultant
Renee started as a U.S. Army combat medic. She went on to run dental and medical offices, including an oral surgery practice, then spent fifteen years inside the VA healthcare system working on workflow, operations, and the decisions that shape care at scale.
Thirty years in, she has seen what happens when the upstream work gets skipped. Today she builds AI governance that protects patients, supports clinicians, and holds up when someone asks for proof.
- in healthcare
- 30 years
- inside the VA
- 15 years
- combat medic
- U.S. Army
“I believe every patient deserves the protection of responsible AI, every clinician deserves governance that supports rather than burdens them, and every healthcare leader deserves a framework that allows innovation and accountability to exist together.”
Build it upstream. Before the gurney arrives.
Bringing Renee to your team? Keynotes, trainings, and bulk copies: lotusaiinnovation.com