Digital Maturity as a Precondition for Scaling AI in a Healthcare Infrastructure

Artificial intelligence (AI) in radiology continues to advance, yet widespread clinical use remains limited. This study examines how digital maturity, defined as the interdependent organisational, technical, and clinical readiness embedded in an existing information infrastructure, shapes hospitals' ability to implement and scale AI. The findings draw on a five-year formative evaluation of Norway's first large-scale deployment of a commercial radiology AI tool. They show that organisational maturity increased through structured change management and locally adapted workflows; technical maturity improved as the organisation shifted from ad-hoc integrations to platform-based and privacy-preserving architectures; and clinical maturity developed as clinicians negotiated responsibility, competence needs, and appropriate use of AI in practice. The study demonstrates that weaknesses in any single dimension constrain progress in the others, and that building digital maturity in parallel is essential for achieving safe, scalable AI integration in healthcare.