For years, the dominant model for health system technology relationships followed a predictable arc. A vendor sold a product, supported an implementation, and largely exited. Whether the tool delivered on its original promise became the health system’s problem to work out.
Cheng-Kai Kao, MD, chief medical information officer at UChicago Medicine in Chicago, said health systems have accumulated a long history of that arrangement and the arrival of AI as a pervasive operational force is making it harder to sustain. Digital health leaders across the country are rethinking what they need from technology partners as AI moves from pilot to enterprise infrastructure.
“If you claim your solution can reduce readmission rate by 30%, well, let’s work together to make it happen,” Dr. Kao said.
The expectation reflects a fundamental shift in how Dr. Kao is approaching vendor relationships. Rather than evaluating a tool’s features in isolation and then absorbing the operational work of making it perform, he wants vendors who will engage with the specific infrastructure and problem landscape UChicago Medicine already has, working through what is in place, what gaps exist, and how technology can be built into actual processes to produce results both sides can measure. Both parties should share in the outcome.
“We have deployed a lot of point solutions in the past where the relationship was more providing the solution. Here is a little technology, deploy this and best of luck,” said Dr. Kao. “But what we really are striving for, especially in the new world where AI has become more pervasive, is infrastructure work. It has become more important.”
Underlying that expectation is a recognition that AI cannot simply be layered onto existing workflows and expected to perform. The infrastructure question — how data flows, where the process breaks, what is already in place — has to be resolved with vendor involvement from the start, not retrofitted after deployment when the original implementation team has moved on.
“We would like to look for vendors that can really sit down and think through this with us,” he said. “What is the infrastructure we have today? What are the problems we’re trying to solve? Then we want to design processes utilizing the technology that it provides to actually solve real world problems that get a result we all want and really share the benefits together.”
As health systems face intensifying pressure to demonstrate ROI on AI spending, the procurement conversation is changing. Leaders are requiring vendors to remain accountable for outcomes past go-live — covering model performance, ongoing monitoring, and results tied to the original promise — a standard increasingly built into contracts before a relationship begins.
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