Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
Norwegian Centre for E-Health Research, University Hospital of North Norway, Tromsø, Norway.
Int J Med Inform. 2024 Apr;184:105377. doi: 10.1016/j.ijmedinf.2024.105377. Epub 2024 Feb 15.
Despite substantial progress in AI research for healthcare, translating research achievements to AI systems in clinical settings is challenging and, in many cases, unsatisfactory. As a result, many AI investments have stalled at the prototype level, never reaching clinical settings.
To improve the chances of future AI implementation projects succeeding, we analyzed the experiences of clinical AI system implementers to better understand the challenges and success factors in their implementations.
Thirty-seven implementers of clinical AI from European and North and South American countries were interviewed. Semi-structured interviews were transcribed and analyzed qualitatively with the framework method, identifying the success factors and the reasons for challenges as well as documenting proposals from implementers to improve AI adoption in clinical settings.
We gathered the implementers' requirements for facilitating AI adoption in the clinical setting. The main findings include 1) the lesser importance of AI explainability in favor of proper clinical validation studies, 2) the need to actively involve clinical practitioners, and not only clinical researchers, in the inception of AI research projects, 3) the need for better information structures and processes to manage data access and the ethical approval of AI projects, 4) the need for better support for regulatory compliance and avoidance of duplications in data management approval bodies, 5) the need to increase both clinicians' and citizens' literacy as respects the benefits and limitations of AI, and 6) the need for better funding schemes to support the implementation, embedding, and validation of AI in the clinical workflow, beyond pilots.
Participants in the interviews are positive about the future of AI in clinical settings. At the same time, they proposenumerous measures to transfer research advancesinto implementations that will benefit healthcare personnel. Transferring AI research into benefits for healthcare workers and patients requires adjustments in regulations, data access procedures, education, funding schemes, and validation of AI systems.
尽管人工智能在医疗保健领域的研究取得了重大进展,但将研究成果转化为临床环境中的人工智能系统具有挑战性,在许多情况下并不令人满意。因此,许多人工智能投资都停滞在原型阶段,从未进入临床环境。
为了提高未来人工智能实施项目成功的机会,我们分析了临床人工智能系统实施者的经验,以更好地了解他们实施过程中的挑战和成功因素。
对来自欧洲以及北美和南美国家的 37 名临床人工智能实施者进行了访谈。对半结构化访谈进行了转录,并使用框架方法进行了定性分析,确定了成功因素和挑战的原因,并记录了实施者提出的改善人工智能在临床环境中采用的建议。
我们收集了实施者在促进人工智能在临床环境中采用的要求。主要发现包括:1)在 favour of proper clinical validation studies 方面,人工智能可解释性的重要性降低;2)需要积极让临床医生参与,而不仅仅是临床研究人员,参与人工智能研究项目的启动;3)需要更好的信息结构和流程来管理数据访问和人工智能项目的伦理批准;4)需要更好的监管合规支持,并避免在数据管理批准机构中重复;5)需要提高临床医生和公民对人工智能的好处和限制的认识;6)需要更好的资金计划来支持人工智能在临床工作流程中的实施、嵌入和验证,而不仅仅是试点。
访谈参与者对人工智能在临床环境中的未来持乐观态度。同时,他们提出了许多措施,将研究进展转化为将使医疗保健人员受益的实施。将人工智能研究转化为医疗保健工作者和患者的利益,需要调整法规、数据访问程序、教育、资金计划和人工智能系统的验证。