AI Is Not a Product. It's Infrastructure.
And that changes everything - for hospitals, for boards, and for the policymakers who shape the system around them.
The dominant narrative still treats Al as a new software category - something to procure from a vendor, deploy in a department, measure ROI on, and slot into existing systems. This view has produced thousands of pilots, hundreds of case studies and research papers, and surprisingly modest impact on actual organisational performance.
That is not a technology problem. It is an organizational one.
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About
About the Book
This is the first essay sharing my thoughts about the transformation needed around AI, and is at ground level, establishing the foundational principles and clarifying why healthcare must treat AI as infrastructure rather than as departmental software.
The second essay I'm developing will dive more deeply into the how-to, how we transition from operational implementation to strategic transformation, addressing the ecosystem approach that extends beyond individual organizations.
That second essay (probably in a series of 3-4) will also explore a critical shift in perspective: how we ourselves become an integral part of this infrastructure, rather than merely being passive users of it.
But first, let's take a clear-eyed look at what is happening now, at the current state of AI implementation in healthcare, why well-intentioned efforts are struggling, and what the actual barriers and opportunities are.
Author
About the Author
I design how healthcare evolves. After years in acute care -ambulance and HEMS- I founded REshape at Radboudumc and now give 100+ keynotes a year across 40 countries, advising health systems, companies and ministries on what AI actually does to care delivery, not what the deck promises. 780,000 people follow the work here; 200,000 more read my newsletters. I work across borders. Rooted in the Dutch ecosystem -Radboudumc, Erasmus MC, Maastricht UMC+, Laurentius MC- I work with health systems in Canada, Spain, the Nordics, Portugal, Africa and the UAE, moving what works in one system into the ones that need it next. Since 2010 I argued that patients should monitor themselves at home on their own devices, that consultations could happen over video, and that patients belonged inside the innovation process itself. I was told it was useless, a waste of time, far-fetched. All three are now standard practice. AI is next.
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