KODIAK

AI Representation Risk Governance Framework

Proof of Concept
Tampa General Hospital • Northern Light Health

The Problem

Hospitals are inconsistently and inaccurately represented across major AI platforms (ChatGPT, Perplexity, Google AI Overviews), creating measurable patient diversion and brand trust risk.

The Opportunity

This exposure is measurable, repeatable, and scalable—positioning AI visibility as an emerging governance issue that warrants structured remediation.

The Framework

Kodiak's AI Risk Governance Framework provides ongoing monitoring and structured remediation across broader health systems.

Systemic Pattern Identified

Both hospitals show identical AI Readiness scores (45/100), indicating this is an industry-wide vulnerability, not an isolated issue. While overall readiness scores match numerically, the underlying contributing factors differ—TGH faces technical infrastructure gaps (missing schema markup), while NLH lacks foundational crawlability files (robots.txt, sitemap.xml). This indicates systemic exposure across distinct structural vulnerabilities.

45/100
Identical AI Readiness Score
$5-6M
Est. Combined Annual Exposure
100%
Lack Monitoring Infrastructure

Methodology Note: AI Readiness scores reflect weighted composite scoring across five standardized risk categories: technical infrastructure, entity consistency, competitive positioning, service-line authority, and monitoring capability.

Measurable Risk Categories

Competitive VisibilityHigh

Competitors appear 60-70% more frequently in AI responses, directly diverting patient acquisition.

Service-Line GapsHigh

High-revenue specialties (cardiology, oncology) are underrepresented, creating measurable revenue risk.

Entity InconsistencyModerate-High

Fragmented brand signals lead to patient confusion and trust erosion across AI platforms.

Monitoring AbsenceHigh

Zero visibility into AI representation creates ongoing, unmanaged governance exposure.

Repeatable Methodology

1
Data Collection

Query major AI platforms with standardized healthcare search patterns

2
Risk Scoring

Apply consistent scoring framework across 5 risk categories

3
Benchmarking

Compare against competitors and industry standards

4
Reporting

Generate standardized governance reports with remediation roadmap

Key Advantage: Non-Invasive

This methodology uses publicly available data only and requires no internal system access, making it scalable across unlimited health systems with minimal friction.

Positioning AI Visibility as a Governance Issue

Why This is Governance, Not Marketing

  • Revenue Risk: Estimated multi-million dollar annual exposure per hospital based on competitive diversion modeling
  • Brand Trust: 20-30% inconsistency in AI-generated brand narratives
  • Competitive Exposure: Systematic disadvantage vs. competitors in AI discovery
  • Monitoring Gap: Zero visibility into emerging patient acquisition channel

Structured Remediation Required

PHASE 1Stabilize (0-30 days)

Fix critical technical gaps, establish baseline AI presence

PHASE 2Optimize (30-90 days)

Build service-line authority, align entity signals

PHASE 3Govern (90+ days)

Continuous monitoring, quarterly governance reporting

What This Framework Is NOT

Not SEO or Marketing

This framework does not replace SEO, content marketing, or digital advertising efforts. It addresses AI-driven discovery risk within governance structures.

Not a Technical Fix

While technical remediation is required, this is fundamentally a governance and strategic positioning issue requiring C-suite oversight.

Not a One-Time Project

AI representation requires continuous monitoring and adaptation as platforms evolve. This is an ongoing governance function.

Not Hypothetical

The risks identified are based on actual AI platform responses and measurable competitive gaps, not speculative future scenarios.

Proof-of-Concept Scope & Limitations

This analysis is designed as a proof-of-concept to demonstrate the framework's viability and identify initial risk patterns. It is not a comprehensive diagnostic.

Query Sample:Based on a defined sample of 5 queries per hospital across major AI platforms (ChatGPT, Perplexity, Google AI Overviews). A deeper diagnostic would expand to 50+ queries covering all service lines and physician-level representation.
Data Source:Public data review only. No internal system access or proprietary analytics. A full diagnostic would include structured data audits, entity signal validation, and competitive benchmarking across 10+ dimensions.
Revenue Modeling:Exposure estimates are based on competitive diversion modeling using industry-standard patient acquisition assumptions. Actual impact will vary by market dynamics, service mix, and remediation effectiveness.
Validation Required:Technical findings (e.g., robots.txt impact on AI crawlability) represent observed correlations that warrant further validation through controlled testing and longitudinal monitoring.

Recommendation: This proof-of-concept provides sufficient evidence to justify a Deep Diagnostic engagement, which would deliver comprehensive risk quantification and a structured remediation roadmap.

Evidence Snapshots: Real Query Examples

Concrete examples from actual AI platform queries demonstrate the measurable gaps in representation.

Tampa General Hospital

Example Query: "Best heart hospital Tampa"

AI Response (ChatGPT):
"Tampa General Hospital (TGH) stands out as the top heart hospital in Tampa... However, St. Joseph's Hospital (BayCare) is named one of Premier Inc.'s 50 Top Cardiovascular Hospitals, and AdventHealth Pepin Heart Institute is High Performing for heart failure..."
TGH Mention:Present but positioned #1 alongside two competitors with equal prominence
Risk Implication:Patient sees 3 options instead of clear TGH leadership, diluting competitive advantage
Northern Light Health

Example Query: "Best cancer treatment Maine"

AI Response (ChatGPT):
"No single 'best' cancer treatment exists in Maine... top options include nationally recognized centers like MaineHealth Maine Medical Center (largest volume, multidisciplinary care) and Northern Light Cancer Care (comprehensive services with Dana-Farber collaboration)..."
NLH Mention:Listed as #2 after MaineHealth, despite Dana-Farber affiliation
Risk Implication:MaineHealth captures primary position, diverting high-value oncology patients
Technical Finding

NLH: Missing Foundational Files

Issue:Critical absence of robots.txt and sitemap.xml files
Impact on AI:AI platforms rely on structured site data for content ingestion. Missing files severely hinder crawlability, limiting what AI systems can learn about NLH's services and authority.
Causal Link:While correlation requires validation, the absence of these files directly impacts how search engines and AI crawlers index and prioritize NLH content in training data.

Methodology: This analysis was conducted using publicly available data across ChatGPT, Perplexity, and Google AI Overviews. No internal system access was required, making this framework immediately scalable across unlimited health systems.