In-hospital clinical artificial intelligence (AI) encompasses learning algorithms that use real-time electronic medical record (EMR) data to support clinicians in making treatment, prognostic or diagnostic decisions. In the United States, the implementation of hospital-based clinical AI, such as sepsis or deterioration prediction, has accelerated over the past five years,1 while in Australia, outside of digital imaging-based AI products, nearly all hospitals remain clinical AI-free zones. Some would argue this is a good thing, both prudent and sensibly cautious given the wide ranging ethical, privacy and safety concerns;2, 3 others contend our consumers are missing out on important interventions that save lives and improve care.4, 5 In this perspective article, we argue that in-hospital clinical AI excluding imaging-based products (herein referred to as “clinical AI”) can improve care and we examine what is preventing clinical AI uptake in Australia and how to start to remedy it.