This sounds familiar, restrictions on financial side.
Inside the restrictions the only way forward is concentrating on internal issues.
I would embrace new technology, especially mobile health. If you do not have Lean method, take it to you – it is cost-efficient. Choose 3-4 main areas of expertise in your hospital (make an internal competition) and give them some extra resources for these 5 years, with a promise of a second competion coming at the end of the 5 years.
“Challenges include ethical issues such as patient confidentiality and legal issues.
Who owns the data?”
This really is a legal issue, different from country to country. In UK and USA you only know after supreme court decisions, in most of other Europe there is mostly legislation but not in every country. So I would lobby politicians in this case.
“How do you develop and maintain trust with patients and referrers?”
Openness is the key. Know what you are doing, explain plainly and completely transparently. Explain a second time, a third time, etcetera. The acceptance grows slowly, but it does grow.
“How does academics and industry work together?”
In AI or other new technologies there is usually same goal, better care. It makes collaboration meaningful. You only have to have solid contracts.
You can break silos only by changing the structure of the organisation. That would make a drift for silos to disappear.
However, especially physicians are specialty-based and naturally have silo mentality from their upbringing.
This is a difficult job, but it can be done. You have to have the hospital leadership with you. Everything should be openly patient-oriented, which shows that silos are enemies of good care.
This is a difficult step, but necessary. Delegating power eventually, often immediately, increases accountability. You should just take the step and see how it develops, it is usually to good direction.
You will actually get feedback soon from the ones who do not want more responsibility, so it does not go hidden. They will tell about their clinical and other workload first. They are the resisters, but most of them get thir act together after their first shock of having leader responsibility. Such persons sometimes become even converts, want more leadership work.