A normative framework for artificial intelligence as a sociotechnical system in healthcare

Melissa D McCradden; Shalmali Joshi; James A Anderson; Alex John London

doi:10.1016/j.patter.2023.100864

A normative framework for artificial intelligence as a sociotechnical system in healthcare

Patterns (N Y). 2023 Nov 10;4(11):100864. doi: 10.1016/j.patter.2023.100864.

Authors

Melissa D McCradden^{1

2

3}, Shalmali Joshi⁴, James A Anderson^{1

5}, Alex John London⁶

Affiliations

¹ Department of Bioethics, The Hospital for Sick Children, Toronto, ON, Canada.
² Genetics & Genome Biology Research Program, Peter Gilgan Center for Research & Learning, Toronto, ON, Canada.
³ Division of Clinical & Public Health, Dalla Lana School of Public Health, Toronto, ON, Canada.
⁴ Department of Biomedical Informatics, Department of Computer Science (Affliate), Data Science Institute, Columbia University, New York, NY, USA.
⁵ Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
⁶ Department of Philosophy and Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA, USA.

Abstract

Artificial intelligence (AI) tools are of great interest to healthcare organizations for their potential to improve patient care, yet their translation into clinical settings remains inconsistent. One of the reasons for this gap is that good technical performance does not inevitably result in patient benefit. We advocate for a conceptual shift wherein AI tools are seen as components of an intervention ensemble. The intervention ensemble describes the constellation of practices that, together, bring about benefit to patients or health systems. Shifting from a narrow focus on the tool itself toward the intervention ensemble prioritizes a "sociotechnical" vision for translation of AI that values all components of use that support beneficial patient outcomes. The intervention ensemble approach can be used for regulation, institutional oversight, and for AI adopters to responsibly and ethically appraise, evaluate, and use AI tools.

Publication types

Review