Hospital CFOs, like those in nearly every other industry, are experimenting with new forms of artificial intelligence and seeing varying degrees of success from such experiments.
A new vendor survey reveals that at least half of the time, hospital tech pilots fail. In a January 2026 survey of 150 U.S.-based hospital CFOs conducted by SmartSense, 60% of respondents said that half or more of their financial or administrative tech pilots fail. These include things such as “revenue cycle automation, financial analytics and AI-driven forecasting,” according to SmartSense, which is a division of Digi International.
Overall, 57% of respondents said that “half or more” of any tech pilot projects fail. That comes even as most respondents (73%) said their organizations are upping their technology budgets this year.
In an interview with CFO.com, SmartSense President Guy Yehiav explained that many hospital tech pilots fail because they don’t have a clear end goal.
“A lot of those projects are driven by the sexiness, the shiny project,” he said. “I think that’s why we found that a lot of those fail.”
Inadequate adoption among employees can also stymie some projects, he noted.
SmartSense’s report calls to mind several others that have raised questions about the ultimate value of artificial intelligence. Last summer, MIT research determined that as many as 95% of organizations using generative AI are getting “zero return” from such initiatives, for instance. And another report by Workday released earlier this year showed that about half of the time employees saved using AI tools was lost correcting faulty outputs.
Yehiav noted that “AI, by itself, doesn’t provide any value.” While the concept remains all the rage in corporate circles, there are times when existing approaches and simpler technology can suffice, Yehiav noted. “What is the thing that you want to solve? Maybe a decision tree will solve 100% of what you want,” he said.
All the same, hospital finance chiefs surveyed by SmartSense are still looking to put money into AI. To wit, 73% of respondents said they plan to invest in the technology to “improve patient experience and clinical outcomes,” while 64% said they’re targeting AI investments to “improve staff experience and operational efficiency.”
But respondents also have high expectations for their investments: Just about half of respondents (51%) said they require returns to “exceed 110% within 18 months, meaning full recovery of initial investment plus an additional 10% in financial gain,” according to the report.
Nineteen percent of respondents said they expect returns to exceed 120% within 12 months, while 26% said they had no strict ROI requirements.
Yehiav said that CFOs ultimately are looking for shorter pilots. “If it fails, shut it off,” he said. “Fail fast and learn.”
As he put it: “CFOs are not going to sign off on innovation unless there’s a clear bottom-line benefit within 12 months.”
Given current cost pressures in the health care space, that’s not entirely surprising. Three-quarters of respondents in SmartSense’s survey said they’re facing higher cost pressures now than in the prior three years.
“Lots of hospitals have negative margins,” Yehiav said.
