Daily Arxiv

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Beyond the Algorithm: A Field Guide to Deploying AI Agents in Clinical Practice

Created by
  • Haebom

Author

Jack Gallifant, Katherine C. Kellogg, Matt Butler, Amanda Centi, Shan Chen, Patrick F. Doyle, Sayon Dutta, Joyce Guo, Matthew J. Hadfield, Esther H. Kim, David E. Kozono, Hugo JWL Aerts, Adam B. Landman, Raymond H. Mak, Rebecca G. Mishuris, Tanna L. Nelson, Guergana K. Savova, Elad Sharon, Benjamin C. Silverman, Umit Topaloglu, Jeremy L. Warner, Danielle S. Bitterman

Outline

To address the gap between potential and practical implementation of LLM-based agents in healthcare settings, we present practical guidelines for deploying generative agents leveraging electronic health record (EHR) data. This guide is based on the experience of deploying the "irAE-Agent" system at Mass General Brigham, which detects immune-related adverse events (irAEs) based on clinical notes, and interviews with 20 clinicians, engineers, and informatics leaders involved in the project. We highlight that over 80% of the actual development effort was spent on sociotechnical tasks for implementation. We identify five key challenges—data integration, model validation, economic value acquisition, system drift management, and governance—and provide actionable solutions for each, shifting the focus from algorithm development to building the infrastructure necessary for practical implementation.

Takeaways, Limitations

Takeaways:
We emphasize that successful deployment of generative AI in healthcare depends more on building infrastructure and practical implementation than on algorithm development.
We provide practical solutions to key challenges such as data integration, model validation, economic value capture, system drift management, and governance.
We provide practical guidance for the practical clinical application of AI systems, helping to apply research findings to real-world settings.
Limitations:
Generalizability of the presented solution: Because it is based on a specific project ("irAE-Agent") and the specific environment of Mass General Brigham, additional adjustments may be required when applied to other healthcare institutions.
Lack of specific technical details: There may be a lack of in-depth discussion of the detailed technical implementation methods for each task.
Lack of consideration for continuous change: There may be a lack of consideration for adapting to and updating the rapid changes in the healthcare environment and technology.
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