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In Episode 5 of Radiology Rewired, Dr. Vivek Singh speaks with Dr. David Stoffel, Chief Business Officer at RapidAI, about what changes when clinical AI moves beyond pilots and becomes part of a hospital’s core infrastructure. Rather than focusing on whether AI works, the conversation looks at how hospitals operationalize AI at scale. Dr. Stoffel shares perspective from across medicine, business, and healthcare technology to explain why leadership decisions, governance models, and shared access determine whether AI actually shapes clinical decisions. Topics include how hospitals move from isolated tools to platforms, why efficiency gains alone rarely justify investment, and what it takes to embed AI into real workflows without adding friction for clinicians. This episode offers a practical, execution-focused view of how clinical AI becomes a durable, system-wide capability inside complex healthcare organizations. Chapters: 00:00 – Introduction: when clinical AI becomes infrastructure 01:10 – Moving beyond AI pilots 02:30 – Why efficiency does not equal impact 03:50 – How hospitals operationalize AI decisions 05:10 – Leadership, governance, and shared access 06:40 – Why integration across specialties matters 08:15 – Stroke care as an infrastructure model 10:05 – Predictive AI and decision-making at scale 12:20 – Avoiding cognitive burden in AI deployment 14:20 – What clinical AI looks like when it sticks