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Volume 17
Issue 12
10.3390/fi17120550
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Systematic Review

The AI-Powered Healthcare Ecosystem: Bridging the Chasm Between Technical Validation and Systemic Integration—A Systematic Review

by
Babiker Mohamed Rahamtalla
1,
Isameldin Elamin Medani
2,*,
Mohammed Eltahir Abdelhag
3,
Sara Ahmed Eltigani
4,
Sudha K. Rajan
2,
Essam Falgy
5,
Nazik Mubarak Hassan
6,
Marwa Elfatih Fadailu
7,
Hayat Ahmad Khudhayr
8 and
Abuzar Abdalla
9
1
Department of Community Medicine, University of Medical Sciences and Technology, Khartoum P.O. Box 12810, Sudan
2
Department of Obstetrics and Gynecology, Faculty of Medicine, Jazan University, Jazan 82722, Saudi Arabia
3
Department of Computer Science, College of Engineering and Computer Science, Jazan University, Jazan 82722, Saudi Arabia
4
Department of Laboratory, Jazan General Hospital, Jazan 45141, Saudi Arabia
5
Department of Biochemistry Lab, Faculty of Medicine, Jazan University, Jazan 82722, Saudi Arabia
6
Department of Health Promotion & Education, Faculty of Public Health & Health Informatics, Umm-Al-Qura University, Taif Road, Mecca 21955, Saudi Arabia
7
Women Health Hospital, Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia
8
Department of Obstetrics and Gynecology, Jazan General Hospital, Jazan 45142, Saudi Arabia
9
Department of Anatomy, Faculty of Medicine, Jazan University, Jazan 82722, Saudi Arabia
*
Author to whom correspondence should be addressed.
Future Internet 2025, 17(12), 550; https://doi.org/10.3390/fi17120550
Submission received: 6 November 2025 / Revised: 24 November 2025 / Accepted: 27 November 2025 / Published: 29 November 2025
(This article belongs to the Special Issue Artificial Intelligence for Smart Healthcare: Methods, Applications, and Challenges)
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Abstract

Artificial intelligence (AI) is increasingly positioned as a transformative force in healthcare. The translation of AI from technical validation to real-world clinical impact remains a critical challenge. This systematic review aims to synthesize the evidence on the AI translational pathway in healthcare, focusing on the systemic barriers and facilitators to integration. Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Web of Science, and IEEE Xplore for studies published between 2000 and 2025. We included peer-reviewed original research, clinical trials, observational studies, and reviews reporting on AI technical validation, clinical deployment, implementation outcomes, or ethical governance. While AI models consistently demonstrate high diagnostic accuracy (92–98% in radiology) and robust predictive performance (AUC 0.76–0.82 in readmission forecasting), clinical adoption remains limited, with only 15–25% of departments integrating AI tools and approximately 60% of projects failing beyond pilot testing. Key barriers include interoperability limitations affecting over half of implementations, lack of clinician trust in unsupervised systems (35%), and regulatory immaturity, with only 27% of countries establishing AI governance frameworks. Moreover, performance disparities exceeding 10% were identified in 28% of models, alongside a pronounced global divide, as 73% of low-resource health systems lack enabling infrastructure. These findings underscore the need for systemic, trustworthy, and equity-driven AI integration strategies.
Keywords: artificial intelligence; healthcare systems; clinical implementation; digital health equity; AI governance; systematic review artificial intelligence; healthcare systems; clinical implementation; digital health equity; AI governance; systematic review
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MDPI and ACS Style

Rahamtalla, B.M.; Medani, I.E.; Abdelhag, M.E.; Eltigani, S.A.; Rajan, S.K.; Falgy, E.; Hassan, N.M.; Fadailu, M.E.; Khudhayr, H.A.; Abdalla, A. The AI-Powered Healthcare Ecosystem: Bridging the Chasm Between Technical Validation and Systemic Integration—A Systematic Review. Future Internet 2025, 17, 550. https://doi.org/10.3390/fi17120550

AMA Style

Rahamtalla BM, Medani IE, Abdelhag ME, Eltigani SA, Rajan SK, Falgy E, Hassan NM, Fadailu ME, Khudhayr HA, Abdalla A. The AI-Powered Healthcare Ecosystem: Bridging the Chasm Between Technical Validation and Systemic Integration—A Systematic Review. Future Internet. 2025; 17(12):550. https://doi.org/10.3390/fi17120550

Chicago/Turabian Style

Rahamtalla, Babiker Mohamed, Isameldin Elamin Medani, Mohammed Eltahir Abdelhag, Sara Ahmed Eltigani, Sudha K. Rajan, Essam Falgy, Nazik Mubarak Hassan, Marwa Elfatih Fadailu, Hayat Ahmad Khudhayr, and Abuzar Abdalla. 2025. "The AI-Powered Healthcare Ecosystem: Bridging the Chasm Between Technical Validation and Systemic Integration—A Systematic Review" Future Internet 17, no. 12: 550. https://doi.org/10.3390/fi17120550

APA Style

Rahamtalla, B. M., Medani, I. E., Abdelhag, M. E., Eltigani, S. A., Rajan, S. K., Falgy, E., Hassan, N. M., Fadailu, M. E., Khudhayr, H. A., & Abdalla, A. (2025). The AI-Powered Healthcare Ecosystem: Bridging the Chasm Between Technical Validation and Systemic Integration—A Systematic Review. Future Internet, 17(12), 550. https://doi.org/10.3390/fi17120550

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