Medical Imaging · AI Strategy · Digital Health

Where clinical depth
meets strategic clarity.

Borealis Health Partners advises health systems and diagnostic AI companies navigating the complex intersection of imaging infrastructure, artificial intelligence, and healthcare transformation. Senior counsel — not a deck factory. A thinking partner with skin in the outcome.

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29yr Domain experience
4 PACS platforms built
70+ Countries deployed
50+ AI deployments
What we do

Advisory built for the complexity of healthcare AI

Two engagement models. Both grounded in 29 years of building at the frontier of diagnostic imaging — not observing it from a distance.

Health System Advisory

Strategic counsel for mid-to-large health systems, regional imaging networks, and diagnostic centres navigating the transition to cloud-native PACS and AI-integrated workflows. The work is specific: vendor selection, RFP architecture, clinical change management, and building the internal case for technology investment — using health economics frameworks that procurement committees actually respect.

  • Cloud PACS strategy, vendor evaluation, and selection support
  • AI adoption roadmaps grounded in clinical workflow reality
  • Value-based health economics analysis (QALY, CADTH, ICER)
  • Procurement architecture and RFP design
  • Clinical change management and radiologist engagement strategy
  • Infrastructure readiness assessment for AI deployment
Primary: Canada  ·  Secondary: US health systems

Imaging AI Startup Advisory

Senior product, strategy, and go-to-market partnership for early-to-growth stage companies building imaging AI, radiology workflow tools, and diagnostic decision support. The gap most founders hit isn't the algorithm — it's the translation layer between clinical evidence, regulatory reality, and how health systems actually buy. That translation is the work.

  • Product strategy and clinical use case prioritization
  • Regulatory pathway navigation (Health Canada SaMD, FDA 510(k))
  • Market sizing, commercial segment analysis, and GTM architecture
  • Health system sales strategy — who decides, what they need to see
  • Physician advisory board formation and clinical validation design
  • Pricing model development grounded in health system budget structures
Market: North America · startup advisory
Why now

The window for AI in radiology is opening — not closing.

Three forces have converged to make this the most consequential inflection point in the history of diagnostic imaging. Understanding them is the difference between leading the transition and managing its aftermath.

Adoption curve

Early Majority — the tipping point is now

Diagnostic AI has crossed the chasm from early adopters into the early majority. This is the phase where vendor relationships consolidate, workflow standards get locked in, and the cost of being late compounds. Health systems that move now secure implementation advantage and validated workflows. Those that wait inherit other people's decisions.

The film-to-digital transition took 15 years. The PACS-to-cloud transition took 8. The AI integration window will move faster — and the organizations best positioned to lead it are the ones engaging now, not after the first RFP cycle closes.

The new math of AI
$30 → $0.15 GPT-4 equivalent cost per million tokens, 2023 → 2025

Inference costs fell faster than Moore's Law ever moved

Use cases that were cost-prohibitive in 2022 are now fully viable at per-study pricing models radiology departments can absorb. The ROI analysis you ran two years ago is wrong. Re-run it.

The structural catalyst
Demographic Crisis
Canada's radiologist-to-population ratio is deteriorating as the population ages faster than the specialist pipeline can grow. Imaging volumes are rising. Read times are under pressure. No amount of hiring solves a structural supply-demand imbalance — workflow AI does.
Productivity Crisis
Canada ranked last in OECD productivity growth — 14 of 16 consecutive quarters negative. The federal government has made productivity a policy priority. Health systems that demonstrate AI-enabled efficiency gains are no longer just managing clinical risk — they are making a political argument that matters to funders.
Cost Crisis
Per-capita healthcare spend is rising faster than provincial budgets can absorb. The question is no longer whether AI investment is justified — it is whether health systems can demonstrate the ROI case compellingly enough to win budget committee approval. That case can be made. Rigorously. Using CADTH-aligned health economics frameworks that funders recognize.
AI in radiology is the lowest-risk, highest-ROI entry point available to Canadian health systems today — and the health economics data to prove it already exists.
The pattern of failure

Big tech keeps getting healthcare wrong. The pattern is consistent.

Microsoft HealthVault. Google Health — twice. IBM Watson Health. Haven. Oracle and Cerner. Six high-profile failures across two decades, each with access to unlimited capital and world-class engineering talent. The common thread was never the technology. It was a fundamental underestimation of what healthcare actually requires: simultaneous fluency in clinical trust, regulatory complexity, and the slow, procurement-driven reality of health system sales cycles.

The organizations that succeed in this market are the ones that understand it from the inside. That understanding is not available off the shelf.

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IBM Watson Health Acquired Merge Healthcare for $1B in 2015. Sold imaging assets six years later. Underestimated clinical workflow complexity at every layer.
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Google Health (1.0 & 2.0) Two separate attempts, 2008–2012 and 2018–2021. ~570 staff redistributed. Division dissolved. Consumer UX thinking collided with clinical reality.
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Haven (Amazon · JPMorgan · Berkshire) Three of the world's most powerful organizations. Disbanded in three years. Misaligned incentives proved more durable than combined market cap.
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Oracle + Cerner $22B acquisition in 2022. Lost 57 hospital customers. Still exploring exit. Enterprise healthcare is not an enterprise software problem.
About

Three domains. Simultaneously. That's the rarity.

Most consultants are deep in one domain. Occasionally two. Meaningful innovation in healthcare requires perfection across all three — at the same time.

Three overlapping domains diagram showing Clinical, Technology, and Business with 29 years at the intersection
29 years at the intersection of all three. The vantage point that cannot be hired, assembled from parts, or replicated by someone who has only observed this industry from the outside.
Work with Stephen
2022 — Present
Director, Innovation & Strategy
Sectra
Leading AI strategy and innovation at one of the world's most trusted medical imaging companies — a global leader in enterprise imaging across radiology, pathology, and orthopaedics. Responsible for translating emerging AI capabilities into clinical and commercial strategy across a global customer base.
2020 — 2022
Senior Director, Product
Arterys (acq. by Tempus)
Tripled the addressable market through strategic repositioning. Brought 2 AI algorithms to market from a pipeline of 200+ in under 6 months. Improved radiologist productivity 2–3×. Built a 30+ site multi-year study across IDNs and independent practices that became the foundation for clinical evidence and go-to-market strategy.
2018 — 2020
Senior Solution Manager, Enterprise Imaging
Change Healthcare
Led portfolio and cultural transformation from departmental PACS positioning to enterprise health system strategy — reorienting the product narrative and sales motion toward the C-suite buying audience that enterprise imaging requires.
2002 — 2018
Product & Marketing Leadership
Agfa HealthCare
Rose from Product Manager to Senior Global Marketing Manager over 16 years. Managed IMPAX — a $693M revenue PACS platform — across 70+ countries. Led GTM strategy and won marquee accounts including Stanford Medicine, Mayo Clinic, and Northwestern Medicine. Built deep fluency in global health system procurement, enterprise imaging architecture, and multi-stakeholder clinical sales.
1997 — 2002
Integration Specialist & Project Manager
Mitra Imaging
Built the first HIS-to-modality integrations via HL7 and DICOM MWL — the foundational protocols that connected radiology information systems to imaging equipment for the first time. Was on the ground as radiology transformed from film to digital. Opened the European office in Eindhoven, Netherlands.
MBA Queen's University
Value-Based Healthcare Harvard Business School
Applied Generative AI MIT Professional Education
Executive Education Stockholm School of Economics
Get in touch

Ready to build something important?

Whether you're a health system evaluating your next imaging platform, a CMIO building the case for AI investment, or a founder navigating the gap between clinical validation and commercial traction — let's find out if we're a fit. Conversations are confidential and without obligation.

stephen@borealishealth.ai
Waterloo, Ontario · Serving Canada & North America