Signal 1 AI Pivots to Management Platform Amidst Healthcare AI Boom
Two prominent figures in the tech and AI landscape, Tomi Poutanen and Mara Lederman, left their high-profile positions in 2022 with a clear mission: to develop artificial intelligence tools designed to enhance patient care, improve health outcomes, and reduce costs within hospitals. Their venture, Signal 1 AI Inc., initially rolled out four distinct applications. One of these tools was engineered to identify patients at the highest risk, necessitating immediate medical intervention, while another focused on streamlining the patient discharge process. Several Canadian hospitals quickly adopted these solutions.
However, a consistent theme emerged from potential clients: the rapid proliferation of AI applications in healthcare. Signal 1 found itself navigating a crowded market, contending with established electronic medical record giants, emerging AI startups, and even hospitals developing their own in-house tools. What these healthcare organizations expressed a genuine need for was a unified system to oversee and monitor the diverse array of AI programs they were implementing. A solution tailored specifically for this purpose was conspicuously absent.
Strategic Shift to AI Infrastructure
Fortuitously, Toronto-based Signal 1 already possessed such a capability. The company had developed an internal AI management system (AIMS) to support its own suite of applications. This internal tool immediately captured the interest of hospitals. Robbie Freeman, chief digital transformation officer at New York City’s Mount Sinai Health System, recalled advising early adopters that “this space was wide open and becoming increasingly important.”
This feedback spurred a pivotal decision in 2025. Signal 1 decided to fully commit to commercializing its AI management system, AIMS. This strategic pivot mirrors successful precedents set by companies like Shopify and Slack, which transitioned from offering direct products to providing the underlying infrastructure that supported their original businesses.
Early Successes and Expanding Adoption
The shift has proven to be highly effective. On Monday, Mount Sinai Health System, which operates seven hospitals and three medical schools, announced its adoption of Signal 1’s AIMS platform. This follows earlier commitments from Inova Health System, a hospital group serving the Washington, D.C. metropolitan area, and another significant, as-yet-unidentified East Coast U.S. academic medical center that became a customer in 2025. In Canada, Nova Scotia Health and Trillium Health Partners are also utilizing the platform.
Dr. Sam Sabbah, chief of staff at Trillium Health Partners, which includes three hospitals in Mississauga, emphasized the critical need for such a system. “More and more, we’re going to see organizations realize that to deploy AI at scale and do it safely, you need a monitoring platform to make sure you’re getting the results that you intend,” Dr. Sabbah stated. He described Signal 1’s platform as “a godsend,” adding, “Without a partner like Signal 1, we would not have the ability to deploy at scale.”
How AIMS Enhances AI Governance and Optimization
Signal 1’s AIMS platform employs its own AI agents to assist clients in evaluating and selecting AI tools for integration into their systems. It then establishes the framework for governing, overseeing, and optimizing the use of these AI applications. Scott McKenna, chief information officer at Nova Scotia Health, highlighted the platform’s value in strategic decision-making: “We have to be deliberate” with spending, he said, adding, “Their platform helps us decide which AI products will be the best investments.”
The platform autonomously monitors all AI applications operating within a healthcare system, encompassing predictive tools, diagnostic imaging software, and generative AI agents. This function acts as a vigilant oversight mechanism, ensuring these tools perform as intended and reporting back to the customer. “If we don’t measure how the AI tools are working, we won’t know if they’re adding value,” explained Mr. Freeman. He further noted the potential for significant harm with AI agents accessing vast patient data, underscoring that “Having the right monitoring, governance and tools like this helps ensure we have a handle on that type of behaviour,” thereby mitigating risk.
For instance, AIMS can track AI-generated draft communications from doctors to patients, verifying their adherence to hospital standards. It also identifies when AI models experience “drift”—a decline in accuracy requiring retraining. Ms. Lederman commented on the complexity involved, stating, “The idea that you’re running 200 agents dipping in and out of your data systems and making phone calls, drafting notes and sending orders to the pharmacy is a whole different level of complexity. That’s why there’s so much excitement for what we’re doing.”
Founders’ Expertise and Early Development
While Canadian hospitals typically utilize fewer than 20 AI tools, with Trillium employing 13, the number is significantly higher in the U.S., with Mount Sinai using 120. Mr. Poutanen anticipates that leading hospitals could eventually deploy over 1,000 AI tools.
The development of the AIMS platform was not accidental. The founders brought extensive industry expertise. Ms. Lederman, formerly a business professor at the University of Toronto’s Rotman School of Management and a leader at the Creative Destruction Lab, took a leave of absence and later resigned her tenured position to dedicate herself to Signal 1, though she remains an adjunct professor. Mr. Poutanen is recognized as a leading AI entrepreneur in Canada. His academic background includes computer engineering studies at the University of Toronto under Professor Geoffrey Hinton, a future Nobel laureate. In 2017, he co-authored Canada’s inaugural AI policy and co-founded the Vector Institute in Toronto, a non-profit dedicated to AI research. Toronto Dominion Bank acquired his startup, Layer 6 AI, in 2018, appointing him chief AI officer. In this role, he was instrumental in fostering trust among bank executives and regulators to support the development of numerous AI tools, including those for high-risk applications like credit underwriting.
“We built a lot of capability around monitoring and ensuring the AI algorithm was running properly and not introducing bias,” Mr. Poutanen shared. “The health-care market had no comparable solution. We built that from day one” at Signal 1, drawing heavily on his experience at TD Bank.
Signal 1 secured US$10-million in seed funding from investors including Inovia Capital, TD, Professor Hinton, and Radical Ventures, where Mr. Poutanen is a partner. The company initially focused on commercializing an intervention care tool developed at Toronto’s St. Michael’s Hospital. However, its underlying platform proved to be the most compelling offering for hospitals as they integrated AI into their operations. Trillium Health Partners sought a Canadian partner to support and monitor its various AI applications, becoming Signal 1’s first platform client in December 2024. Recognizing the rapid evolution of AI, Trillium aimed for “infrastructure to plug in solutions as they evolve,” according to Dr. Sabbah, rather than committing to specific applications.
A pivotal moment occurred at a Signal 1 offsite meeting in March 2025, where founders debated the company’s strategic direction: “Do we go all in on the platform or on applications,” Mr. Poutanen recounted. He described the period as “stressful. We were stretched thin. The market was confused about our identity.”
The decision to focus on the AIMS platform appears to have been prescient. The company’s revenue is now reportedly in the mid-single-digit millions annually, and Mr. Poutanen stated, “our business has been on a rocket ship ever since.”
