AI and project management in healthcare

Column

Health

February 25, 2026

AI and project management in healthcare

Why technology alone cannot transform systems

Artificial intelligence is being presented as one of the main promises for the future of health. Faster diagnoses, process automation, more precise decisions, and cost reduction are part of a discourse increasingly present in institutional agendas. However, practical experience shows that simply investing in technology does not guarantee organizational transformation or sustainable improvement in care.

Recent reports indicate that Brazil has a promising scenario for the use of artificial intelligence in healthcare, but still faces relevant limitations in infrastructure, professional qualification, and data governance (CETIC.BR, 2024). In practice, it is observed that many projects are initiated with great expectation and end up underutilized, fragmented, or without measurable impact.

The implementation of digital health solutions has revealed a recurring pattern: the prioritization of the acquisition of technologies over the understanding of the organizational and operational complexity required for their implementation. This misalignment frequently results in costly systems, low adherence by teams, and limited impacts on work processes. This demonstrates that digital transformation does not stem from the isolated adoption of technologies, but from the development of structured projects, with clearly defined governance, method, and purpose.

When innovation fails before it begins

Contemporary literature on innovation highlights the importance of distinguishing between two forces driving technological change — technology-push (technological supply) and demand-pull (market needs) — and how these forces interact to guide the direction of innovation. Hötte (2023), in a recent study, points out that when initiatives are primarily based on technology-push, they can generate innovations misaligned with real demands, with implications for project adoption and sustainability.

Initiatives driven exclusively by technology tend to present strategic fragility, poorly defined scope, and low organizational integration (Bento et al., 2022). Without an adequate institutional diagnosis institutional, systems do not connect to workflows, do not dialogue with real demands, and are not incorporated into routine. In these contexts, innovation becomes an isolated experiment, without continuity or effective value generation.

The strategic role of project management

The management of projects traditionally involves the planning and control of deadlines, costs, and scope. In the field of digital health, however, its role expands, assuming a structuring function in transformation processes, articulation of actors, and support for organizational changes.

According to the Association for Project Management (2022), AI-based projects require integration between technical, organizational, and human skills. This includes translating clinical demands into technical requirements, organizing multidisciplinary teams, planning training, and defining performance indicators. Without this arrangement, technology remains a promise. With it, it becomes a management tool.

Efficiency is not just automation

The initial applications of artificial intelligence in healthcare usually focus on the automation of administrative and management support processes, such as scheduling, billing, auditing, demand triage, and analysis of claims (payment rejections by health plans).

These uses represent relevant advances in operational efficiency. However, as AI began to be incorporated into care, regulatory, and decision-making processes — such as clinical decision support, risk stratification, health surveillance, care network management, and data governance —, it became evident that its benefits remain limited when not accompanied by organizational redesign, workflow review, and adequate governance mechanisms.

Real gain occurs when technology is inserted into projects that revise flows, integrate systems, and qualify teams. Studies show that successful initiatives combine technological innovation with structural changes in management models (Torres et al., 2025). In this scenario, project management acts as a mediator between technical, clinical, and administrative areas, ensuring institutional coherence.

Clinical decision support and accountability

In the assistance dimension, decision support systems are expanding rapidly. Image analysis, exam interpretation, remote monitoring, and risk prediction are already part of the reality of many services.

International reviews indicate that artificial intelligence can increase diagnostic accuracy and reduce clinical response time, provided it is accompanied by validation and human supervision (Uridge et al., 2025). However, its indiscriminate adoption can generate new problems, such as decision opacity, algorithmic bias, and legal fragility, for example.

Responsible projects need to incorporate, from the beginning, mechanisms for explainability, auditing, and governance. Studies on Explainable Artificial Intelligence highlight that algorithmic transparency is a central condition for institutional trust (Arrieta et al., 2020). Without this care, technical gain may be accompanied by loss of credibility.

Interoperability: the invisible challenge

Much of the difficulties in implementing artificial intelligence are not in the algorithms, but in the infrastructure. Fragmented data, incompatible systems, and lack of standards make promising projects unfeasible.

International experiences, such as that of the National Health Service (NHS) in England, demonstrate that healthcare systems with low interoperability face structural obstacles to the adoption of advanced solutions — especially slow, fragmented, and user-unfriendly basic IT systems, which prevent the effective integration of advanced solutions like AI, because the essential data infrastructure is neither modernized nor interoperable (The Guardian, 2024).

In Brazil, this challenge is widely recognized in the sectoral studies of the Regional Center for Studies for the Development of the Information Society (CETIC/BR, 2024). Project management plays a decisive role in this context, articulating intersectoral agreements, defining priorities, and organizing transition stages.

Ethics, LGPD and data governance

It is still common to treat privacy, information security and legal compliance as final steps. This is a strategic mistake. AI operates with sensitive data, which requires strict adherence to the General Data Protection Law (Brazil, 2018). Failures in this area not only lead to legal sanctions but also compromise institutional legitimacy.

Mature projects incorporate, from the conception, analysis of regulatory risks, legal participation, data protection policies, and accountability mechanisms. Governance does not limit innovation. It makes it sustainable.

People continue to be the decisive factor

No technology can sustain itself without human adoption. Resistance to change, professional insecurity, and low digital literacy are still relevant obstacles. Studies indicate that many projects fail not due to technical limitations, but due to failures in change management (Salimimoghadam et al. 2025). Ignoring this aspect compromises any initiative.

Successful projects invest in internal communication, continuous training, user participation, and active listening from teams. Digital transformation is, above all, a social process.

The accumulated experience in different contexts allows us to highlight some fundamental principles:

  • Define the problem before the tool;
  • Work with structured pilots;
  • Incorporate governance from the start;
  • Plan organizational change;
  • Measure real impact.

These elements differentiate lasting projects from fleeting initiatives.

Beyond technology

Artificial intelligence can contribute significantly to the strengthening of the Brazilian healthcare system. However, this requires coordination between public policies, professional training, adequate regulation, and governance models.

Sector reports indicate that the consolidation of this agenda depends on institutional development and the qualification of managers (CETIC.BR, 2024). Importing solutions without building local capacities tends to generate technological dependence and operational fragility. Artificial intelligence has the potential to increase efficiency, support clinical decisions, and strengthen health management. But it does not operate alone.

The difference between projects that generate impact and those that become obsolete lies in the quality of their management. Technology is the engine. Project management is the steering system. Without planning, governance, and institutional commitment, innovation disperses. When these elements are present, it transforms into social value.

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Who wrote this column

Beatriz Cristina de Freitas

Doutora pela UNICAMP, é mestre em Ciências da Saúde pela UnB e em Telessaúde e Saúde Digital pela UERJ, com especializações em Gestão de Projetos (USP/ESALQ) e Gestão em Saúde (USP/EERP). Atua como professora e pesquisadora nas áreas de inovação, políticas públicas de saúde, saúde digital e gestão de projetos aplicados à saúde.

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