AI Has Crossed From Advising To Acting: Your AI Strategy Hasn't Caught Up

Heather Bassett, MD, is Chief Medical Officer with Xsolis, an AI-driven health technology company fostering payer-provider collaboration.

​As a physician, I learned early that a recommendation and an order are not the same thing: one informs judgment, the other changes what happens next. That distinction now matters in how leaders think about AI.

For most of the past decade, enterprise AI stayed on the recommendation side of that line. In healthcare, a model flagged a patient at risk, scored a claim or surfaced a pattern. A person decided what to do next. The technology informed the work, but it did not carry the work forward.

That line is starting to blur. Emerging agentic systems can assemble information, draft correspondence, trigger next steps and follow up when something is missing. Most still operate in bounded workflows under human oversight, and they should. But AI is beginning to move from generating an answer to carrying work forward.

That changes the strategic question. Leaders still need to know whether a model is accurate and useful, and whether it treats people fairly. A strategy built for recommendation tools falls short for systems that can act. It also has to address what the system may do, where it must stop and how we will know if it acts wrongly.

AI strategy has to follow the action.

Organizations have spent years building processes to evaluate decision-support tools. In healthcare, we ask how a model was trained, whether it performs across populations, how its output is explained and who reviews the recommendation. Those questions still matter, but they no longer cover an agent or the strategy around it.

A strategy for agentic systems cannot be just a list of use cases, vendors and models. It has to define how AI fits into daily operations: which workflows are appropriate, which actions may be delegated, how we measure performance and who remains accountable. Governance turns those choices into enforceable boundaries.