Why Mayo Clinic's CFO Is Focused on Creating an Ecosystem

Dennis Dahlen explains why the system is prioritizing ecosystem-building, long-term flexibility, and commercial discipline as it advances the Mayo Clinic Platform and prepares for rapid shifts in digital and agentic AI.

As Mayo Clinic accelerates its digital transformation through Mayo Clinic Platform_Insights, an initiative designed to give health systems of all sizes across the globe access to digital expertise, data-driven insights and clinical knowledge, CFO Dennis Dahlen says the system is taking a deliberately long-term, ecosystem-first approach, one that he believes is essential for innovation to truly flourish.

A Broader Definition of ROI

Facing the same cost pressures, labor constraints, and reimbursement uncertainty challenging so many health systems across the country, Mayo Clinic is taking a deliberately long-term view in how it evaluates return on investment for its Platform Insights and emerging technology initiatives.

Dahlen, who has led financial strategy at major health systems since 1999 and served as the national chair of the HFMA, describes the approach as intentionally flexible in the early phases of innovation.

"I'll admit to using a lighter touch here at Mayo Clinic on return parameters for these investments … in developmental areas including the platform," he said.

 While acknowledging that these investments will eventually be held to traditional business metrics, he stresses that enforcing rigid ROI thresholds too early would risk choking off its transformative potential.

Dahlen recalls Mayo board member Eric Schmidt advising the organization to suspend ROI rules for projects in early development so as not to "kill them before they manifest anything useful."

For Dahlen, the long-term payoff isn't just financial, ; it's structural.

"The long-term ROI… is to support the development of an ecosystem… that will allow everyone to accelerate discovery and advance medicine through more meaningful collaborations across the globe," he said.

Some of that value, he adds, is "really big and really hard to put numbers to, but also really game-changing for the human species."

Even with early-stage flexibility, Mayo maintains an enterprise-wide capital allocation discipline, one Dahlen says has helped it achieve high performance.

"The new space isn't an afterthought. It's almost off the top — first call on capital for these developmental areas," he said.

Leadership sees investment in innovation as essential to maintaining industry position.

"If you stay in the leadership position you have to chart your own course… choose your own pace and keep moving," he added.

Rather than betting on individual technologies, Mayo is building an adaptive ecosystem that can absorb new tools as they emerge.

Dahlen even notes that "Agentic AI… wasn't even on our radar when we started Mayo Clinic Platform and now it represents a significant enabler and contributor to the potential of this platform ecosystem."

This adaptability, he said, allows "course corrections to incorporate new tools… changing market conditions, or even innovations from others."

A Commercial Model for Sustainability

Mayo is not treating its platform as a cost center.; the new entities created through the initiative are expected to generate returns, according to Dahlen.

"We do expect them to create value for us and others and provide tangible financial rewards in the forms of both royalty and equity, which Mayo Clinic then reinvests into patient care, discovering more cures and educating the healthcare workforce of the future," he said.

Generative and agentic AI expand those opportunities, he says, creating "whole new streams of innovation… that expand the horizons" of what the ecosystem can support.

How Mayo Assesses ROI on Digital Tools

Dahlen acknowledges that digital health tools often fall outside traditional financial models, but argues that "with enough discernment you can find a sort of traditional ROI measure. There's value created somehow."

Mayo grants "a grace period upfront" for early-stage development, especially within platform initiatives. But expectations tighten as products near commercialization.

"Once you get to the point of a commercially viable or minimum viable product and you want to start scaling it, that's the point where we start to put in more rigorous ROI requirements," he said.

Borrowing from venture-capital discipline, Mayo examines burn rate, capital needs, expected returns, and timing:

"How am I going to get it back and in what time frame? How long does it take for the flywheel effect to establish itself?" he said.

The Strategic Message for CFOs

Rather than investing in point solutions with limited shelf life, Mayo is designing a structure that can continuously integrate new capabilities.

"It's not in any way a point solution — it's that holistic ecosystem that solves for myriad challenges and iterates as users add more and better data." Dahlen said.

As CFOs navigate rapid digital change, Mayo's model offers a roadmap: Invest in adaptable architectures, balance strategic patience with commercial rigor, and ensure long-term financial durability by letting the ecosystem, rather than any single technology, anchor the strategy.