Careers: Interviews
A Chat with Paul Swider: 30+ years building tools that add hours back to a clinician's day; CEO and Chief AI Officer at RealActivit; Founder, BOSHUG; Microsoft Certified Trainer

This week, Stephen Ibaraki has an exclusive interview with Paul Swider.

Paul Swider has spent more than 30 years at the intersection of healthcare and technology, not talking about AI transformation but building it. In 2001 he designed a symbolic AI triage engine that eliminated pre-operative anesthesia visits and accelerated same-day surgery pathways.

In late 2023 his team shipped Provider Activity Studio, the world's first AI harness for hospital administration. In 2024 they shipped Wheelhouse Frontier, a model fine-tuned on PeopleSoft healthcare operations data and executive prompt workflows. In 2025 they open-sourced Tula, a patient agent built on OpenClaw, and Paul became the first to pull Epic MyChart data into a personal OpenClaw health agent. In 2026 they shipped Aria, a governance plane for patient agents, and drafted the dual-spec architecture for AI skills in healthcare.

In between, he trained more than 3,000 engineers across GE, IDX and Microsoft in enterprise software patterns, migrated over 50 HIPAA workloads to Azure, and built the CMS compliance and activity reporting platforms that health systems still rely on. He is a Microsoft MVP alumnus and a Microsoft Certified Trainer, and was recognized as Azure Most Influential for implementation rather than evangelism.

Today he is CEO and Chief AI Officer at RealActivity, a Microsoft Cloud Partner delivering mission-critical AI for academic medical centers and health systems across the United States, Asia, the Middle East and Latin America. That work includes system-wide clinical time tracking through Provider Activity, using an approach accepted by CMS as an alternative methodology, alongside governed AI for operational workflows that reduces administrative burden and protects provider time. He also founded OCS Labs, an AI lab focused on industry-specific AI for government and regulated sectors.

He founded BOSHUG, the Boston Healthcare Cloud and AI Community, and continues to help grow its global network. He is also a Cloud Wars healthcare AI analyst.

A global citizen based in Greater Boston, Paul can otherwise be found in a Sicilian bakery arguing about lemon cake, or sailing, snowboarding, diving and planning the next adventure. 114 countries and counting.

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