This paper presents findings from a formative process evaluation of the implementation of a commercial AI application in a large Norwegian hospital trust. The study identified three key areas critical for successful AI adoption: (1) Implementation strategies, (2) Implementation methods, and (3) Effects and values. We examine how the hospital developed a bottom-up implementation strategy, emphasizing a “learning by doing” approach. The iterative implementation method, refined across multiple hospitals, prioritized extensive stakeholder involvement and rigorous quality assurance. This approach facilitated key outcomes, including enhanced digital maturity, early benefits realization, and strengthened user trust and engagement—essential factors for long-term AI adoption.