Artificial intelligence is gaining traction across healthcare, but for many hospitals the challenge isn’t adoption, it’s affordability.

That reality took center stage during the 2026 AAMI eXchange session “AI-Based Medical Technologies and HDO Equipment Needs,” where healthcare technology management (HTM) leaders discussed how financial pressures, aging infrastructure, and cybersecurity demands are shaping AI investment.

“We’re standing at a fascinating time,” said moderator Robert Kerwin, general counsel for IAMERS. “On one hand, AI promises to revolutionize patient care. On the other hand, there are real challenges with financial and cybersecurity concerns.”
Those challenges are already affecting hospitals’ ability to invest in new technology, said panelist Mike Powers, network director of biomedical engineering at St. Luke’s University Health Network in Bethlehem, Pennsylvania. He pointed to ongoing cuts in Medicare and Medicaid reimbursement, noting that many health systems continue to serve patient populations heavily dependent on those programs.

“We’re struggling with keeping the doors open,” Powers said. “We want to invest in new technologies, and AI will supposedly help us save money. But how do we get from here to there?”

As a result, many hospitals are extending the life of existing equipment rather than replacing systems outright. Panelist Stephen Grimes, managing partner and principal consultant at Strategic Healthcare Technology Associates, described growing interest in “AI wrappers”, which are software layers designed to enhance legacy systems without requiring full replacement.

In imaging, that can mean improving image quality or diagnostic performance on equipment nearing the end of its life cycle. What was once viewed as a temporary workaround is increasingly becoming a long-term strategy. But extending the life of connected equipment introduces new risks.

Grimes said purchasing decisions are no longer driven solely by clinical performance. Total cost of ownership now includes cybersecurity exposure, vendor support, patch timelines, and the challenges associated with securing aging systems.

And cybersecurity pressures, in particular, are intensifying. Powers said vulnerabilities can be exploited within minutes of disclosure, while manufacturers often require weeks or months to deliver validated fixes. That gap is pushing hospitals toward broader mitigation strategies, including network segmentation and device isolation, rather than reliance on patch cycles alone.

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