As health systems race to integrate generative AI into clinical workflows, TidalHealth CIO and CMIO Mark Weisman, MD, is taking a methodical approach — one focused on financial accountability.
The Salisbury, Md.-based health system has formed an AI committee composed of physicians, nurse practitioners, physician assistants and a researcher to better understand AI utilization within the organization.
“As we bring new tools in, they’re reviewed by the committee. The group is only six or seven months old, but we plan to do annual reviews to evaluate what we’re spending — especially on ambient AI tools, which is the biggest category right now,” Dr. Weisman told Becker’s. “We’re not measuring ROI yet, because there’s really no good way to define the value of these tools. Instead, we’re tracking spending.”
Dr. Weisman said the organization is hyperfocused on understanding its AI-related spending to help leadership make informed decisions about the tools entering clinical workflows, how they’re being adopted and what it takes to maintain them.
“There are new tools entering the market that are game changers for healthcare — but we need to know what they cost,” he said. “These tools don’t come with added reimbursement, they’re not generating new revenue, and we’re not asking physicians to see more patients. At the very least, we need to understand the financial impact.”
When it comes to the cost of generative AI tools entering the healthcare marketplace, Dr. Weisman said the price tag remains high.
“There’s still a high cost in this space, even with growing competition — so much so that vendors are starting to cannibalize their own,” he said. “We’re seeing some of the larger players become more competitive on price, because they’re focused on gaining market share. They understand now that switching is difficult. Once a provider becomes comfortable with an AI tool, they’re unlikely to want to change.”
At the same time, health systems are becoming more selective about which vendors they partner with.
“Some vendors pitch themselves as platforms offering a broad suite of tools, but often we’ve engaged with them for just one specific capability. Yet they want to charge us for the full platform, which can be frustrating,” Dr. Weisman said. “That’s why we’re seeing CIOs push back on the all-in-one platform model and be more discerning.”
According to Dr. Weisman, CIOs typically prefer to work with a few large, trusted vendors rather than a multitude of niche players. But when it comes to AI, they’ve made exceptions.
“Sometimes a smaller vendor offers a targeted use case that makes sense for us. In those cases, we’re willing to give them a shot,” he said. “It’s often more affordable, and frankly, we’re not ready to put all our eggs in one basket — especially not yet. Over time, I do think the market will consolidate, but we’re not there just yet.”
As a result, CIOs are increasingly pushing back on how vendors license and package their products.
“We have to make it clear: their licensing model doesn’t align with how our clinicians actually work,” Dr. Weisman said. “Some doctors are in the OR, some are researchers, some are educators. If they’re not using the tool full time — like when they’re performing surgery — they shouldn’t be charged as if they are.”
TidalHealth has made it clear to vendors: If you’re not flexible, we’ll explore competitors. Some have responded by adjusting pricing models in a way that makes more sense for healthcare.
Dr. Weisman urged fellow CIOs to be firm with vendors and demand models that reflect clinical realities.
“My advice to other CIOs is to do the same — challenge vendors when their models don’t fit our reality. They need to understand we’re not traditional office workers using word processors nine to five. We need pricing structures that reflect how clinical work is actually done. And if they can’t adapt, we’ll go elsewhere,” he said.
