“Should we buy or build?” is usually the first question organizations ask about radiology AI. It is useful, but it is no longer the whole question.
Today, you can choose from cleared clinical algorithms, enterprise AI platforms, generative-AI tools, and internally developed workflows. The real challenge begins after a contract is signed or a prototype works. AI becomes another clinical system: one that can help, distract, confuse, or quietly change behavior.
Anyone who has lived through an enterprise IT rollout, PACS replacement, or hospital merger (let alone lead an aspect of it) knows the pattern. Installation is only one part of deployment. The hard work is making a tool fit the people, data, incentives, exceptions, and failure modes of the place where it will be used.
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