Healthcare systems face a critical question: build custom AI tools tailored to their workflows, or buy ready-made solutions? This video unpacks the operational, financial, and clinical factors that inform that decision, including insights on cost, customization, integration, and innovation in patient-centered AI. Dr. Sanjay Juneja (https://sjunejamd.com/) interviews Dr. Harvey Castro (https://www.linkedin.com/in/harveycastromd/) to explore the nuances of AI adoption in hospital systems. They break down the value of federated learning, ambient scribe technologies, cultural considerations in care, and how to ensure AI models support rather than replace clinical decision-making. If you're in health system leadership, clinical informatics, operations, or product strategy, this discussion offers frameworks to guide smarter, sustainable AI investments.