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However, despite rapid technological advancement and preliminary adoption accelerated by the COVID\u201019 pandemic, a significant implementation gap persists. This narrative review explores the causes of this gap, highlighting several examples from early development to final implementation. These show that technical validation alone is insufficient. Success depends on alignment with clinical need, robust external validation, patient empowerment and sustainable funding models. Furthermore, other systemic barriers include data privacy concerns and lack of transparency by commercial companies. To improve adoption and translate promise to practice, more international alignment of regulations and international collaboration is needed. Lessons must be learned from promising initiatives that did not reach clinical care, as much as from their successful counterparts. 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