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Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes

One of the key challenges in successful deployment and meaningful adoption of AI in healthcare is health system-level governance of AI applications. Such governance is critical not only for patient safety and accountability by a health system, but to foster clinician trust to improve adoption and fa...

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Autores principales: Liao, Frank, Adelaine, Sabrina, Afshar, Majid, Patterson, Brian W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448877/
https://www.ncbi.nlm.nih.gov/pubmed/36093386
http://dx.doi.org/10.3389/fdgth.2022.931439
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author Liao, Frank
Adelaine, Sabrina
Afshar, Majid
Patterson, Brian W.
author_facet Liao, Frank
Adelaine, Sabrina
Afshar, Majid
Patterson, Brian W.
author_sort Liao, Frank
collection PubMed
description One of the key challenges in successful deployment and meaningful adoption of AI in healthcare is health system-level governance of AI applications. Such governance is critical not only for patient safety and accountability by a health system, but to foster clinician trust to improve adoption and facilitate meaningful health outcomes. In this case study, we describe the development of such a governance structure at University of Wisconsin Health (UWH) that provides oversight of AI applications from assessment of validity and user acceptability through safe deployment with continuous monitoring for effectiveness. Our structure leverages a multi-disciplinary steering committee along with project specific sub-committees. Members of the committee formulate a multi-stakeholder perspective spanning informatics, data science, clinical operations, ethics, and equity. Our structure includes guiding principles that provide tangible parameters for endorsement of both initial deployment and ongoing usage of AI applications. The committee is tasked with ensuring principles of interpretability, accuracy, and fairness across all applications. To operationalize these principles, we provide a value stream to apply the principles of AI governance at different stages of clinical implementation. This structure has enabled effective clinical adoption of AI applications. Effective governance has provided several outcomes: (1) a clear and institutional structure for oversight and endorsement; (2) a path towards successful deployment that encompasses technologic, clinical, and operational, considerations; (3) a process for ongoing monitoring to ensure the solution remains acceptable as clinical practice and disease prevalence evolve; (4) incorporation of guidelines for the ethical and equitable use of AI applications.
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spelling pubmed-94488772022-09-08 Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes Liao, Frank Adelaine, Sabrina Afshar, Majid Patterson, Brian W. Front Digit Health Digital Health One of the key challenges in successful deployment and meaningful adoption of AI in healthcare is health system-level governance of AI applications. Such governance is critical not only for patient safety and accountability by a health system, but to foster clinician trust to improve adoption and facilitate meaningful health outcomes. In this case study, we describe the development of such a governance structure at University of Wisconsin Health (UWH) that provides oversight of AI applications from assessment of validity and user acceptability through safe deployment with continuous monitoring for effectiveness. Our structure leverages a multi-disciplinary steering committee along with project specific sub-committees. Members of the committee formulate a multi-stakeholder perspective spanning informatics, data science, clinical operations, ethics, and equity. Our structure includes guiding principles that provide tangible parameters for endorsement of both initial deployment and ongoing usage of AI applications. The committee is tasked with ensuring principles of interpretability, accuracy, and fairness across all applications. To operationalize these principles, we provide a value stream to apply the principles of AI governance at different stages of clinical implementation. This structure has enabled effective clinical adoption of AI applications. Effective governance has provided several outcomes: (1) a clear and institutional structure for oversight and endorsement; (2) a path towards successful deployment that encompasses technologic, clinical, and operational, considerations; (3) a process for ongoing monitoring to ensure the solution remains acceptable as clinical practice and disease prevalence evolve; (4) incorporation of guidelines for the ethical and equitable use of AI applications. Frontiers Media S.A. 2022-08-24 /pmc/articles/PMC9448877/ /pubmed/36093386 http://dx.doi.org/10.3389/fdgth.2022.931439 Text en © 2022 Liao, Adelaine, Afshar and Patterson. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Digital Health
Liao, Frank
Adelaine, Sabrina
Afshar, Majid
Patterson, Brian W.
Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes
title Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes
title_full Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes
title_fullStr Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes
title_full_unstemmed Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes
title_short Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes
title_sort governance of clinical ai applications to facilitate safe and equitable deployment in a large health system: key elements and early successes
topic Digital Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9448877/
https://www.ncbi.nlm.nih.gov/pubmed/36093386
http://dx.doi.org/10.3389/fdgth.2022.931439
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