From AI Pilots to Operational Health Systems: Reflections Before Madrid

In a few days, I will return to Madrid to participate in the OECD International Conference on the Responsible Scale of AI in Health.

This journey feels personally meaningful.

Madrid was my home for nearly 15 years — a city where I raised my children, built friendships, learned, struggled, and grew professionally before the world changed during COVID. Returning now, in the context of a global conversation about the future of healthcare, data, and AI, carries a special emotional weight.

As I review the preparatory materials shared by the OECD, one idea keeps resonating strongly with me:

The challenge facing healthcare is no longer simply about developing more AI.

The real challenge is whether our health systems are truly ready to operationalise AI responsibly, sustainably, and at scale.

The conversation appears to be shifting:

• from technology itself,
• towards governance, interoperability, workforce readiness, trust, real-world implementation, and the enabling foundations needed for meaningful transformation.

Perhaps this is the beginning of a new phase.

Not the phase of AI hype.
But the phase of operational health systems.

These reflections also connect deeply with many of the ongoing conversations we have been nurturing through the Health Data Forum and the emerging Real Data, Better AI initiative — particularly as we prepare for the upcoming Health Data Forum Global Hybrid Summit in Bilbao this September under the theme "EHDS in Practice".

For now, I am mostly looking forward to listening, learning, reconnecting with colleagues, and contributing to what feels like an increasingly important international dialogue.

Madrid once played an important role in my personal life.

Perhaps, in a different way, it may also help shape the next chapter of this collective conversation around trustworthy AI in health.

Paul Nunesdea, PhD, CPF | Paulo Nunes de Abreu
Health Data Forum Firestarter https://healthdataforum.org