There are different and evolving views about the ultimate and instrumental aims of a health system, and by extension of a health institution, or a health service. We believe that when discussing the possible advantages and challenges of the application of AI in healthcare, it can be extremely helpful to have a framework that categorises the value that the new application can provide. In this chapter, we review different views of value in healthcare, their definitions and measures, and present a framework that we call operational excellence that will be useful to understand what is being innovated, what is the expected value impact of different digital innovations in the healthcare ecosystem, including the applications based on AI and ML. The framework focuses on operational areas that can be acted on, to separate them from the outcomes’ perspective. The three principal areas of action are technical excellence, process excellence, and service excellence. After the introduction of the framework, we apply it to review several applications of AI in healthcare and conclude with a description of the challenges faced, a comment on their relative importance as well as some suggestions to deal with them.