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What comes next for responsible AI in healthcare: An international multi-stakeholder perspective on building interconnected health-system infrastructure for implementation
ABSTRACT
The central challenge facing AI in healthcare is no longer the absence of ethical guidance. Rather, it is the need for sufficiently developed and integrated organisational, regulatory, technical, operational, and educational infrastructure to translate ethical principles into routine practice. Existing implementation frameworks have made important advances in translating ethical principles into guidance across the AI lifecycle. However, responsible AI implementation also requires broader health-system infrastructure and capabilities that extend beyond individual AI systems. Building on these efforts, this roadmap takes a broader health-system perspective, focusing on the interconnected infrastructure and capabilities needed to enable responsible AI implementation across healthcare. Through a multi-stakeholder deliberative process involving two international convenings, followed by iterative synthesis and refinement by contributors, we developed a roadmap comprising five interconnected implementation pillars. These are: (1) ethical governance across the AI lifecycle; (2) regulatory and implementation coherence and governance alignment; (3) fair, explainable, trustworthy, and empowering AI; (4) operational tools and governance mechanisms; and (5) AI literacy, capacity building, and inclusive participation. The roadmap translates these priorities into health-system infrastructure and capabilities, priority actions, and the stakeholders with key roles in their implementation. Together, the five pillars frame responsible AI as an interconnected health-system implementation challenge requiring coordinated action across the healthcare ecosystem.
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Copyright
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