Deirdre K. Mulligan

Jee Young Kim, William Boag, Freya Gulamali et al.

Private and public sector structures and norms refine how emerging technology is used in practice. In healthcare, despite a proliferation of AI adoption, the organizational governance surrounding its use and integration is often poorly understood. What the Health AI Partnership (HAIP) aims to do in this research is to better define the requirements for adequate organizational governance of AI systems in healthcare settings and support health system leaders to make more informed decisions around AI adoption. To work towards this understanding, we first identify how the standards for the AI adoption in healthcare may be designed to be used easily and efficiently. Then, we map out the precise decision points involved in the practical institutional adoption of AI technology within specific health systems. Practically, we achieve this through a multi-organizational collaboration with leaders from major health systems across the United States and key informants from related fields. Working with the consultancy IDEO [dot] org, we were able to conduct usability-testing sessions with healthcare and AI ethics professionals. Usability analysis revealed a prototype structured around mock key decision points that align with how organizational leaders approach technology adoption. Concurrently, we conducted semi-structured interviews with 89 professionals in healthcare and other relevant fields. Using a modified grounded theory approach, we were able to identify 8 key decision points and comprehensive procedures throughout the AI adoption lifecycle. This is one of the most detailed qualitative analyses to date of the current governance structures and processes involved in AI adoption by health systems in the United States. We hope these findings can inform future efforts to build capabilities to promote the safe, effective, and responsible adoption of emerging technologies in healthcare.

Deirdre K. Mulligan, Joshua A. Kroll, Nitin Kohli et al.

The explosion in the use of software in important sociotechnical systems has renewed focus on the study of the way technical constructs reflect policies, norms, and human values. This effort requires the engagement of scholars and practitioners from many disciplines. And yet, these disciplines often conceptualize the operative values very differently while referring to them using the same vocabulary. The resulting conflation of ideas confuses discussions about values in technology at disciplinary boundaries. In the service of improving this situation, this paper examines the value of shared vocabularies, analytics, and other tools that facilitate conversations about values in light of these disciplinary specific conceptualizations, the role such tools play in furthering research and practice, outlines different conceptions of "fairness" deployed in discussions about computer systems, and provides an analytic tool for interdisciplinary discussions and collaborations around the concept of fairness. We use a case study of risk assessments in criminal justice applications to both motivate our effort--describing how conflation of different concepts under the banner of "fairness" led to unproductive confusion--and illustrate the value of the fairness analytic by demonstrating how the rigorous analysis it enables can assist in identifying key areas of theoretical, political, and practical misunderstanding or disagreement, and where desired support alignment or collaboration in the absence of consensus.