DIME PROJECT

Implementing AI in Healthcare

SECTION 2 | CHOOSE THE RIGHT TOOL

Your procurement path: Build, buy, or partner?

Many health systems are leaning toward building or co-developing solutions to better align with local data, workflows, and clinical priorities. But off-the-shelf tools are evolving fast in domains like medical imaging and ambient documentation and can offer quicker paths to ROI if well-matched to your environment. (View this real-world example.)

Each choice entails very different implications for who owns what, who supports what, and how the tool gets deployed, monitored, and maintained. Here’s a framework of what to consider before committing to a path:

Choosing whether to build in-house, buy off-the-shelf, or partner to co-develop an AI solution is a workforce and organizational capability decision at its core.

Criteria	Build	Partner	Buy
Customization	Fully tailored to your workflows	Joint customization	Limited; vendor-defined features
Time to value	9–24+ months	4–12 months	2–6 months
Total cost of ownership (TCO)	High upfront development and long-term operating costs	Shared development cost and predictable operating costs	Lower upfront cost; ongoing license and integration fees
Internal skill requirements	Data scientists, clinical informatics, validation, DevOps	Project management, domain experts, vendor integration oversight	Vendor management, IT enablement
Maintenance responsibility	Fully internal: You handle updates, retraining, clinical tuning, and regulatory monitoring	Shared maintenance protocols, joint model tuning	Vendor-maintained, but you still own performance monitoring and safety
Integration lift	Very High: Custom APIs, full-stack build	High: Shared architecture, integration complexity	Moderate: Vendor must meet your API standards and integrate into existing systems
Regulatory burden	Full accountability for compliance, validation, safety reporting	Shared compliance; contracts must clarify responsibilities	Vendor takes lead, but system still accountable for safe, compliant use
Strategic fit	Best when no commercial solution exists or deep customization is essential	Best for complex, evolving needs that benefit from shared innovation	Best for standardized use cases with mature market solutions
Example use case	Building a tailored triage algorithm for a safety-net ED population	Co-developing a sepsis prediction model with an academic partner and vendor	Buying an ambient documentation tool from a major vendor with EHR-certified integration

Decision checkpoint

Build

Do we have internal AI build capacity (including DevOps, model validation, clinical informatics, and security)?

Read how Stanford Health Care developed internal tools with a multidisciplinary team of clinicians, IT, researchers, and more.

Buy

Do we have a well-functioning procurement process, legal review, and capacity to support integration and vendor accountability?

Partner

Are we structured to co-lead a development process, including shared validation, legal negotiations, and dual deployment governance?

Read how Artium and Arrive Health built a prior authorization tool together.

All models

Have we mapped this sourcing decision to our long-term implementation plan—including workforce support, total cost of ownership (TCO), monitoring, and regulatory compliance?

PRO TIP

Deployment & support questions to answer now

Who will monitor the model’s performance and safety in real-world use?
Who owns retraining, updates, and re-validation?
How will clinicians be trained and supported over time?
Do we have the IT and data infrastructure to support this model?
What governance structure will oversee change management and risk?

From the strategic leader

A vendor’s quoted license fee is rarely the full story. In reality, the total cost of ownership (TCO) of implementing, from integration to long-term maintenance ends up being much more expensive than the initial licensing fee.

Avoid budget overruns. Finance and IT leaders should model the full lifecycle cost, including upfront capital, ongoing operating expenses, and end-of-life decommissioning.

See the TCO Breakdown

Next steps

It’s time to pressure-test potential solutions. Use the Health AI Evaluation Guide to cut through vendor claims, validate tools against your data and workflows, and build a shortlist ready for real-world deployment.

Health AI Evaluation Guide