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In musculoskeletal health care, AI is poised to assume an emerging role in improving diagnostic accuracy, guiding treatments, and powering robotic surgical approaches. Compared with other nonsurgical specialties, this field is uniquely positioned for adopting innovations driven by AI given that treatment decisions are often dependent upon complex synthesis of unstructured data and imaging. Given these opportunities and the potential benefits for patient care, many academic medical centers have sought to establish leadership positions surrounding AI as well as dedicated AI centers to coordinate AI initiatives. The objectives of institutional AI centers include fostering collaboration and innovation in AI applications both internally and with existing industry players, improving patient outcomes and value through innovation, optimizing workflow efficiency, and establishing institutional leadership in health care AI. This article provides a comprehensive review of considerations for establishing AI centers in academic institutions, with an emphasis on workflow optimization, automation of administrative tasks, clinical decision support, and robotic surgery in the context of musculoskeletal health care as an example.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V, expert opinion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70094","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:13:57Z","timestamp":1774829637000},"page":"681-688","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Establishing a Sustainable Artificial Intelligence Center of Excellence for Health Care Systems: Part I\u2014Strategic Frameworks, Infrastructure, and Performance Metrics"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0363-3482","authenticated-orcid":false,"given":"Kyle N.","family":"Kunze","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashis","family":"Barad","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2025.01.064"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-024-09893-z"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2023.03.028"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.03.033"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-024-01208-3"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/AIoa2300068"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-024-02136-1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2024.1475092"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocad258"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-024-08956-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.08.009"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.09.013"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.01.043"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.12.006"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.12.011"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3414\/ME0569"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.34976"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.12.010"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.23.0404"},{"key":"e_1_2_9_21_1","unstructured":"Palantir.AI platforms delivering speed and impact to healthcare's frontlines.2025. 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