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Why AI Isn’t Delivering P&L Impact

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Episode Summary

Svetlana Makarova, AVP of AI Technical Product Management at IKS Health, joins Imran Mian on Behind the Growth to break down what’s actually happening inside organizations trying to adopt AI. She starts by outlining a fragmented landscape where some companies move quickly due to internal capability, while others struggle with change management and foundational readiness before AI can even be applied.

From there, Svetlana challenges how AI progress is measured; while many reports highlight productivity gains and positive sentiment, she explains that most organizations are not seeing direct business impact because they are not changing underlying workflows. Instead, they are accelerating existing work using copilots and SaaS tools, without rethinking how work gets done or tying initiatives to meaningful outcomes.

The conversation then shifts to where AI efforts stall. Svetlana points to people, skills, and organizational alignment as the primary blockers, not technology. Teams are often asked to implement AI without sufficient fluency, while leadership expectations are disconnected from execution realities. This creates friction across data, governance, and adoption efforts, with resistance and uncertainty playing a major role.

Looking ahead, she outlines what it takes to move forward. Workforce readiness depends less on technical fluency and more on judgment, domain expertise, and practical application. AI transformation happens gradually, starting with small use cases, building institutional capability, and evolving toward deeper workflow changes over time.

Featured Guest

  • Name: Svetlana Makarova
  • What she does: AVP, AI Technical Product Management
  • Company: IKS Health
  • Noteworthy: Svetlana Makarova is an AI product leader and strategist with experience leading enterprise AI initiatives in healthcare. She has led AI work at organizations like Mayo Clinic, focusing on deploying AI in complex, regulated environments and helping teams move from pilots to production with measurable outcomes. Her work spans AI product development, enterprise strategy, and large-scale transformation. She is also a doctoral candidate in Applied AI/ML and a frequent keynote speaker.

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Key Insights

AI adoption is constrained by organizational readiness and capability
AI adoption varies significantly across organizations because internal capability, not access to tools, determines progress. Some companies are able to move quickly because they already have the technical skills and structures in place, while others, especially service-based organizations, must first navigate change management and workflow transformation. This creates a fragmented landscape where adoption is uneven and often slower than expected. For enterprise leaders, this reinforces the need to invest in foundational capability, internal fluency, and operational readiness before expecting meaningful results from AI initiatives.

Productivity gains alone do not translate into business impact
Organizations are seeing measurable productivity improvements from AI tools, particularly through copilots and SaaS solutions. However, these gains often come from accelerating existing tasks rather than transforming how work is done. As a result, they do not translate into meaningful business outcomes like P&L impact. Without rethinking workflows or targeting problems that directly affect the business model, AI remains an efficiency tool rather than a transformation driver. There is a dire need to align AI initiatives with operational change rather than expecting results from incremental improvements.

People and organizational alignment are the primary blockers
AI initiatives stall most often due to gaps in people, skills, and alignment—not technology. Teams are frequently expected to implement AI without the necessary fluency, leading to hesitation and stalled execution. At the same time, leadership visions can be disconnected from what teams are capable of delivering, creating friction and unrealistic expectations. Even challenges related to data and governance are ultimately tied to human capability. Senior leaders must understand the importance of investing in workforce readiness, aligning expectations, and building the internal capability required to execute AI initiatives effectively.

You're giving your employees faster tools, but you're not transforming the workflows.

Episode Highlights

AI Adoption Is Fragmented

AI adoption varies widely across organizations, driven by differences in internal capability and readiness. While some companies can move quickly due to strong technical foundations, others face additional layers of change management before they can meaningfully adopt AI. This creates a divided landscape where progress is uneven and dependent on internal maturity.

“I think we see AI adoption being quite fragmented… you have companies that are much more adapt to apply the technology or learn AI much faster just because they have the skill sets internally.”

Productivity Doesn’t Equal Transformation

Many organizations report productivity gains from AI, but those gains often come from speeding up existing work rather than changing it. Without transforming workflows or targeting meaningful business problems, these improvements do not translate into real business outcomes like P&L impact.

“If you’re not changing anything inherently into the existing workflows, why would you expect the P&L impact?”

AI Stalls Because of People

AI initiatives often fail due to human factors rather than technical limitations. Lack of fluency, resistance to change, and misalignment between leadership and teams create friction across adoption efforts. Even issues with data and processes ultimately trace back to people.

“any adoption… the challenges can be attributed to 70 % people, 20 % data and processes and 10 % algorithms.”

AI Needs Human Judgment

AI can identify patterns and generate outputs, but it lacks the deeper insight that comes from human expertise. The ability to interpret results, connect them to business context, and make decisions remains a human responsibility.

“It’s gonna see the very common surface level patterns, but the things that you’re gonna see in that data and that next level insight… is the expertise that you bring.”

Transformation Takes Time

AI transformation is a gradual process that requires building internal capability over time. Organizations cannot expect immediate, large-scale change without first developing skills, governance, and experience through smaller initiatives.

“you shouldn’t shoot for a complete transformation within your organization within two years if you still haven’t upskilled your teams…”

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