Adoption of artificial intelligence in healthcare: survey of health system priorities, successes, and challenges.

Importance: The US healthcare system faces significant challenges, including clinician burnout, operational inefficiencies, and concerns about patient safety. Artificial intelligence (AI), particularly generative AI, has the potential to address these challenges, but its adoption, effectiveness, and barriers to implementation are not well understood.

Objective: To evaluate the current state of AI adoption in US healthcare systems, assess successes and barriers to implementation during the early generative AI era.

Design, setting, and participants: This cross-sectional survey was conducted in Fall 2024, and included 67 health systems members of the Scottsdale Institute, a collaborative of US non-profit healthcare organizations. Forty-three health systems completed the survey (64% response rate). Respondents provided data on the deployment status and perceived success of 37 AI use cases across 10 categories.

Main outcomes and measures: The primary outcomes were the extent of AI use case development, piloting, or deployment, the degree of reported success for AI use cases, and the most significant barriers to adoption.

Results: Across the 43 responding health systems, AI adoption and perceptions of success varied significantly. Ambient Notes, a generative AI tool for clinical documentation, was the only use case with 100% of respondents reporting adoption activities, and 53% reported a high degree of success with using AI for Clinical Documentation. Imaging and radiology emerged as the most widely deployed clinical AI use case, with 90% of organizations reporting at least partial deployment, although successes with diagnostic use cases were limited. Similarly, many organizations have deployed AI for clinical risk stratification such as early sepsis detection, but only 38% report high success in this area. Immature AI tools were identified a significant barrier to adoption, cited by 77% of respondents, followed by financial concerns (47%) and regulatory uncertainty (40%).

Conclusions and relevance: Ambient Notes is rapidly advancing in US healthcare systems and demonstrating early success. Other AI use cases show varying degrees of adoption and success, constrained by barriers such as immature AI tools, financial concerns, and regulatory uncertainty. Addressing these challenges through robust evaluations, shared strategies, and governance models will be essential to ensure effective integration and adoption of AI into healthcare practice.