Digital Transformation of Rural, Regional, and Remote Australian Hospitals: A Pragmatic Strategy for Introducing <scp>AI</scp>

AIMS: Rural, regional, and remote hospitals in Australia face barriers to digital transformation, including limited infrastructure, digital literacy, and workforce capacity. This Commentary outlines a pragmatic strategy to build rural digital readiness through the safe implementation of ambient artificial intelligence (AI) scribes as a low-risk starting point for AI adoption. CONTEXT: AI scribes use generative AI to convert clinical conversations into documentation. They offer potential to reduce administrative burden and workforce strain while preparing rural health services for future AI use. Although the Victorian Department of Health has established minimum standards for AI scribe use, rural hospitals face unique challenges including lower AI literacy, workforce pressure, and limited research infrastructure. Insights from ongoing implementation research highlight the value of simulation methods to examine usability, workflow effects, and ethical considerations before deployment. APPROACH: Three key enablers support responsible implementation: (1) clinical simulation for research, (2) harmonisation of evaluation metrics, and (3) shared infrastructure for consent, training, and monitoring. CONCLUSION: Implementing AI scribes provides a practical pathway for rural hospitals to strengthen capability, reduce administrative burden, and build readiness for more advanced clinical AI, supporting safe and equitable adoption across rural Australia.