The New England Journal of Medicine’s just-released NEJM AI publication is off to the races, with its February issue including a stellar breakdown of how academic medical centers are managing the influx of predictive models and AI tools.
Researchers identified three governance phenotypes for managing the AI deluge:
- Well-Defined Governance – health systems have explicit, comprehensive procedures for the evaluation of AI and predictive models.
- Emerging Governance – systems are in the process of adapting previously established approaches for things like EHRs to govern AI.
- Interpersonal Governance – a small team or single person is tasked with making decisions about model implementation without consistent evaluation requirements.
Regardless of the phenotype, interviews with AI leadership at 13 academic medical centers revealed that chaotic implementations are hard to avoid, partly due to external factors like vague regulatory standards.
- Most AI decision makers were aware of how the FDA regulates software, but believed those rules were “broad and loose,” and many thought they only applied to EHRs and third party vendors rather than health systems.
AI governance teams report better adherence to new solutions that prioritize limiting clicks for providers when they’re implemented. Effective governance of prediction models requires a broader approach, yet streamlining workflows is still a primary consideration for most implementations. That’s leading to trouble down the road considering predictive models’ impact on patient care, health equity, and quality care.
Even well-equipped academic medical centers are struggling to effectively identify and mitigate the countless potential pitfalls that come along with predictive AI implementation. Existing AI governance structures within healthcare orgs all seem to be in need of additional guidance, and more guardrails from both the industry and regulators might help turn AI ambitions into AI-improved outcomes.