In healthcare, we’ve layered AI initiatives on top of governance structures that were never designed to support them, and then expressed surprise when the ROI doesn’t materialize. The problem isn’t the model, the vendor, or even the CAIO. It’s that strategic mandate, executive alignment, and value measurement — three of your eight dimensions — are rarely resolved before the initiative launches.
What I’ve observed firsthand: the organizations that can articulate precisely what problem AI is solving, who owns the outcome, and how success will be measured before a single dollar is committed are the ones that compound their advantage over time.
We have a fundamental AI leadership gap to understand the transition from the information age to an imagination age. The ones that burden the bottom leadership with problem-solving AI solutions using tools-first ideology and skip the imaginative diagnostic design thinking are the ones that come back twelve months later, budget depleted, asking why nothing moved.
Originally posted on X (@kothapalli_dr).
