In this episode of the NEJM AI Grand Rounds podcast, Dr. Nigam Shah, a distinguished Professor of Medicine at Stanford University and inaugural Chief Data Scientist for Stanford Health Care, shares his journey from training as a doctor in India to becoming a leading figure in biomedical informatics in the United States. He discusses the transformative impact of computational tools in understanding complex biological systems and the pivotal role of AI in advancing health care delivery, particularly in improving efficiency and addressing systemic challenges. Dr. Shah emphasizes the importance of real-world integration of AI into clinical settings, advocating for a balanced approach that considers both technological capabilities and the systemic considerations of AI in medicine. The conversation also explores the democratization of medical knowledge, why open-source models are under-researched in medicine, and the crucial role of data quality in training AI systems.