4.1 Artificial intelligence (AI) multi-disciplinary teams (MDTs)

The responsibilities of AI MDTs could include the below.

• Drive development of novel AI solutions or co-create AI technologies with industry innovators.
• Consider the needs and views of stakeholders and patients across diverse backgrounds, and seek to involve other experts and members of the public when developing AI technologies.
• Co-ordinate engagement with industry innovators and act as a conduit between the 2 sectors.
• Facilitate the introduction of AI technologies including technical integration, systems change management and education of users.
• Lead the ethical governance and implementation of AI technologies at their settings.
• Evaluate potential AI technologies to assess their suitability for local deployment, including the need for local validation, prospective clinical studies, and assessing technical requirements.
• Ensure clinical safety, manage the reporting process for possible safety incidents and establish appropriate back up processes.
• Undertake ongoing post-deployment monitoring, surveillance and audits of AI technologies to ensure they continue to perform safely and effectively.
• Evaluate the impact of AI technologies on clinical pathways, including review process efficiencies and patient outcomes.
• Design, deliver and continually update product-specific user education.

This fictional case study is based on an integrated care system (ICS) team working to co-create an imaging-based AI technology with an industry innovator within a healthcare setting. It complements the fictional case study presented in Box 2.

The aim of this case study is to outline the types of roles and responsibilities of individuals within the AI MDT team, and their relation to the archetypes discussed in this report. It should only be considered as an illustrative example rather than a fixed structure or blueprint as AI MDT size, structure and roles will vary depending on needs, products and local factors.

The AI MDT should represent all teams working for commissioning, developing, and implementing an AI technology, as well as the full range of its users. The team should be diverse in terms of demographics, levels of seniority, and familiarity with digital health to ensure fairness for both staff and patients.

All product and organisation names used in this case study are fictional.

Summary

A chest X-ray triaging AI product (tri-X) is co-designed between the Linchester ICS and an industry innovator, Triadix. The technology is designed to help manage the radiology workflow by prioritising chest X-rays for reporting by radiologists. The project AI MDT comprises key individuals involved with or affected by the development and implementation of tri-X.

ICS Digital Transformation Lead – Driver

• Oversee the work of the AI MDT, championing their role and advocating for appropriate funding and resourcing of the team.
• Ensure the appropriateness of the AI solution to ICS needs and clinical workflows.
• Commission Triadix as a commercial partner to co-create tri-X and manage their contractual relationship, including intellectual property, data sharing agreement and commercial commissioning agreements for the wider roll out of tri-X.
• Ensure that appropriate regulatory standards are being adhered to when creating tri-X and the product development aligns with appropriate guidelines.

Radiology Business Manager – Driver

• Consider impact of tri-X on finance, human resources, training and sustainability.
• Help to define business case and outcome measures that will address real world system benefits to the ICS radiology service.
• Conduct service level risk assessment, and oversee service continuity and decommissioning planning.

Clinical Specialist - Radiology Consultant – Creator/User

• Define clinical scope of the product and advise on workflow integration plan at the design stage, including representation of a diverse range of users.
• Conduct clinical risk assessment and develop mitigation plan.
• Review validation performance and prospective clinical studies of tri-X.
• Advise on systems change processes involved in the introduction of tri-X.
• Support creation and delivery of product-specific user education for tri-X to ICS radiologists alongside Embedder colleagues.
• Use tri-X in clinical work.

Clinical Product Manager – Creator

• Undertake problem discovery sessions with stakeholders, map out workflows and explore the clinical issue to be solved by tri-X.
• Define the scope of use and requirements for tri-X.
• Liaise with clinical experts including ICS radiologists to ensure that the product is clinically robust and is integrated strategically into clinical workflows.
• Co-create tri-X with users. Conduct regular user research sessions to get feedback on how to improve the product and add value to users.
• Ensure tri-X aligns with safety and regulatory standards, working closely with Linchester ICS safety and regulatory team from the outset.
• Coordinate with ICS data science teams and clinical specialists to conduct prospective clinical studies of tri-X, in line with Linchester ICS requirements and national evidence for efficacy.

Lead Project Data Scientist – Creator/Embedder

• Oversee the ICS data and clinical science team working on technical aspects of creation, validation and embedding of tri-X, including:
  • analysis of the data set available to address the problem, evaluating the data for representativeness, potential bias and generalisability and ensuring it is of appropriate quality
  • working alongside Triadix data scientists and software engineers to create, test and improve the tri-X AI model, iterating until accepted accuracy and safety levels are reached using internal test data
  • overseeing validation of the final algorithm using internal and external validation data sets, as well as conducting prospective clinical evaluation studies in collaboration with users and Triadix team
  • assessing the regulatory compliance of tri-X
  • conducting post-market follow up to assess and monitor performance, and act upon any model drift
  • creating and delivering product-specific user education for tri-X alongside clinical MDT colleagues

Clinical Safety Officer – Embedder

• Conduct a clinical safety review and risk assessment of tri-X.
• Ensure there are appropriate protocols in place for systems failure, fall-back workflows, reporting errors and on-going monitoring.
• Consider mitigation plan for potential risks of deskilling, if relevant.

Information Technology (IT) Officer – Embedder

• Lead the technical implementation of tri-X including systems integration, data and cyber security, data storage, system robustness and availability.
• Provide ongoing advice and support for users of tri-X.

Information Governance (IG) Officer – Embedder

• Lead integration with existing information governance processes or development of new processes as needed for the tri-X project, providing guidance from early in the project ideation stage through to deployment.