ViVE 2026: Accountability Is Reshaping Healthcare AI

ViVE 2026 was my first major industry gathering as Newfire’s Chief Growth Officer, and it provided a grounded view of where healthcare innovation is truly heading. After attending sessions and speaking with leaders across the ecosystem, five clear takeaways emerged. The energy around AI is real—but so is the pressure. Margins are tight, scrutiny is higher, and execution gaps are becoming more visible. What follows are five practical observations leaders can use to prioritize smarter, sequence better, and align innovation with measurable impact over the next 12 to 24 months.

Pressure meets possibility: a market that’s growing up

If I had to summarize the mood at ViVE 2026 in one phrase, it would be disciplined optimism.

There’s real excitement around AI. You couldn’t walk the floor without seeing “AI,” “agentic AI,” or “automation” in bold across booths. The energy is there. But so is pressure.

Most healthcare technology companies are selling into hospitals and health systems operating on razor-thin margins. Federal funding uncertainty and ongoing Medicaid pressures only amplify that reality. Buyers are sharper than ever, and they’re looking for demonstrable impact on either reducing costs or increasing revenue. Or as one attendee put it: “The math has to make sense.”

That mindset defined the conference. At the same time, I wouldn’t call this a pessimistic market, but a maturing one.

The optimism comes from the fact that AI is no longer theoretical. Leaders are convinced it can drive meaningful change. But conviction alone isn’t enough. The market is separating signal from noise. Companies that can quantify impact are moving forward. Those relying on marketing headlines are facing tougher conversations.

My takeaway for healthcare? In 2026, innovation must be tied directly to operational outcomes. If you can’t articulate the financial or efficiency story behind your technology, the market will force you to.

On the surface, that looks like anxiety. To a market-trained eye, it’s accountability.

AI is moving beyond pilots, but infrastructure is the gatekeeper

Yes, AI was everywhere at ViVE. But when you strip away the marketing language, the conference largely confirmed an industry truth: the most consequential AI developments are operational, almost boringly so.

The use cases that felt most credible to me were focused on fixing the messy backend infrastructure that defines American healthcare: claims processing, mid-cycle coding, workflow optimization, AI-assisted scheduling. None of that is glamorous, but it directly touches cost structure and workforce efficiency. That’s where near-term value is most likely to emerge.

There’s a real difference between adding a chatbot layer and deploying AI in a way that meaningfully reduces manual effort or shortens a revenue cycle. Some companies are starting to push beyond basic automation. But I would still say that in many cases, pilots are getting bigger rather than organizations fully moving to scaled ROI.

Innovation in healthcare takes time. It runs into infrastructure. It runs into systems of record. It runs into integration challenges. So I’m optimistic about the direction, but realistic about the pace.

For the practical healthcare leader, my recommendation is this: focus AI investment on operational friction points that already have measurable metrics attached to them. Revenue cycle. Administrative burden. Staffing constraints. If you can’t clearly connect the use case to cost reduction or revenue impact, it’s going to be a hard sell in this environment.

The discipline around where and how AI is applied is what will separate signal from noise.

The messy middle will define the winners

The most insightful sessions and conversations all had the same refrain: before you can do the exciting AI work, you have to build the bridge.

A lot of companies are talking about agentic workflows and advanced automation. But those ambitions run headfirst into the reality of healthcare infrastructure. You can’t deploy meaningful AI until you’re connected to core EMRs and other key infrastructure platforms like ServiceNow. This work is foundational but often gets treated as secondary.

ViVE made it clear there’s no shortage of AI ideas. In many cases, what’s missing is the plumbing to support them.

I spoke with teams that have strong ideas and capable engineers, but they’re discovering that integration into the healthcare ecosystem is more complex and time-consuming than expected. Data formats are inconsistent. Governance is evolving. Access isn’t always straightforward. You have to “plug into the matrix” before anything intelligent can run on top of it.

The companies that accept that reality early — and invest in interoperability, clean data, and platform readiness — will move faster over time. The ones that try to skip it may build impressive demos but struggle to scale in production environments.

From a practical standpoint, this means prioritizing integration strategy alongside AI strategy. If your roadmap includes advanced automation, your roadmap should also include systems connectivity, data standardization, and governance design.

It’s not the headline work. But it’s the work that determines whether the headline ever becomes real.

Building the right things will matter more than building fast

AI is lowering the barrier to building new capabilities. That’s one of the most powerful shifts underway. But it also introduces a new risk: it’s becoming easier to build the wrong things.

When development cycles compress and tooling accelerates, the bottleneck shifts from engineering capacity to decision quality. The question isn’t just, “Can we build this?” It’s, “Should we?”

At ViVE, I saw a lot of creativity. A lot of experimentation. That’s healthy. But in a market that’s demanding demonstrable financial impact, product roadmap discipline becomes critical. Every new feature, every automation initiative, every AI enhancement needs to tie back to a clear operational lever: cost reduction, throughput, revenue acceleration, workforce efficiency.

Otherwise, you’re adding complexity without improving performance.

This is where strong product management becomes a strategic advantage. The organizations that win won’t necessarily be the ones that build the most AI features. They’ll be the ones that prioritize ruthlessly, sequence intelligently, and align innovation to measurable business outcomes.

In this environment, it’s clarity over speed. The leaders I spoke with aren’t looking for more ideas. They’re looking for focus.

Why independence matters in an accountability market

As Newfire’s new Chief Growth Officer, ViVE gave me the opportunity to sit down face to face with clients for the first time and understand where they want to go over the next 12 to 24 months, and what’s standing in their way. One theme came up repeatedly: pressure. Margins are tight. Budgets are scrutinized. Every initiative needs to justify itself.

In that kind of environment, alignment matters.

I was reminded in several conversations how unusual it is that Newfire operates without financial sponsorship or external pressure dictating short-term outcomes. We don’t have investors pushing us toward a particular narrative or forcing artificial growth targets. Our decisions are grounded in what’s right for the customer and what actually works in the field.

That independence shapes how we approach transformation work.

When the market demands measurable impact, ego doesn’t help. Overpromising doesn’t help. Flashy positioning doesn’t help. What helps is disciplined execution, practical integration, and a roadmap tied to real business performance.

Healthcare innovation right now isn’t about bold declarations. It’s about building responsibly, sequencing intelligently, and delivering outcomes that hold up under financial scrutiny.

The mood at ViVE reflected that shift. And for those willing to do the foundational work, there is real opportunity ahead.

Carrying the Discipline Forward

ViVE 2026 reinforced something I’ve believed for a long time: sustainable growth in healthcare comes from aligning technology to business reality and executing with discipline. The conversations I had made it clear that the opportunity around AI is real, but it will reward organizations that connect infrastructure to innovation, align product strategy to measurable outcomes, and sequence transformation in a way that holds up under financial scrutiny.

That perspective will guide how I approach growth in the months ahead—focusing on clarity over noise, substance over positioning, and partnerships built on operational performance. The market is asking harder questions. That’s a healthy shift. And for teams willing to do the foundational work, there is meaningful momentum to build.