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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Sep 23, 2026
Date Accepted: Sep 28, 2026

The final, peer-reviewed published version of this preprint can be found here:

Shadow AI and the Limits of Institutional Agility

Rader B, Brownstein JS

Shadow AI and the Limits of Institutional Agility

J Med Internet Res 2026;28:e112827

DOI: 10.2196/112827

Shadow AI and the Limits of Institutional Agility

  • Benjamin Rader; 
  • John S. Brownstein

ABSTRACT

Physicians are adopting generative AI tools faster than health systems can evaluate them. This commentary argues that governing this "Shadow AI" requires health systems to pair institutional speed with transparent, stakeholder-engaged governance.


 Citation

Please cite as:

Rader B, Brownstein JS

Shadow AI and the Limits of Institutional Agility

J Med Internet Res 2026;28:e112827

DOI: 10.2196/112827

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