DIGEST

Three years ago, a hospital CTO could evaluate AI tools in isolation. Sepsis prediction here. Radiology triage there. The procurement model was familiar: RFP, pilot, contract, integrate. The integration was the hard part, but it was a known hard part.

That era is ending. Epic's AI-native features, Oracle Health's Clinical AI, and Microsoft Nuance's ambient documentation have collapsed what was once a rich ecosystem of point solutions into a binary choice: bet on your EHR vendor's AI roadmap, or build a parallel infrastructure layer that will require perpetual maintenance.

The Aurelius Genomics round announced this week is instructive. Their 340-day average sales cycle — remarkable by enterprise health IT standards — is partly a product of selling into innovation officers who have already made the platform bet and are now selectively layering complements. The genomics use case is narrow enough to avoid threatening the EHR vendor, and valuable enough to justify a standalone budget line.

The harder question is what happens to the companies selling adjacent to the core workflow. Remote patient monitoring. Clinical decision support. Prior authorization automation. These are exactly the spaces where Epic, Oracle, and Microsoft are expanding. The window for independent category leaders may be narrower than the funding data suggests.