[Artificial intelligence for italian medicine: navigating between innovation and practice]

"Artificial intelligence is transforming healthcare": this sentence is now so common it risks losing meaning. Technology alone does not change systems, people do: clinicians, researchers, decision-makers, and patients. AI is a lever, but without a fulcrum of skills, vision, and responsibility, it moves nothing. This conviction is at the core of the Italian Society for Artificial Intelligence in Medicine (SIIAM) and of the 3rd Annual Meeting (Naples, October 10-11, 2025). Our aim is not to celebrate technology for its own sake, but to bring together a multidisciplinary community capable of deciding how to use AI responsibly in the Italian healthcare system. This issue of Recenti Progressi in Medicina presents the collective output of this effort: commentaries by the Scientific Committee and contributions from participants. It is shown how rules and principles can be translated into practice, how Italian healthcare can evolve toward a Learning Health System, and why responsible infrastructures and evaluation frameworks are needed to guide AI innovation. Case studies highlight both promising advances and pitfalls to avoid. The central question is not whether AI will change medicine, but how we can use it to have a more equitable, proactive, sustainable and personalized one? If the lever is AI, the fulcrum remains the people and organizations who care for others. It is on this fulcrum that SIIAM continues to work, with rigor, openness, and trust, so that innovation becomes daily practice for the benefit of patients and professionals alike.