Censinet found
that only 59 percent of health systems
have a formal approval process
before deploying clinical AI.
Four in ten deploy
with nothing behind the decision.
Stop adopting clinical AI.
Start operationalizing it.
Those are not the same instruction.
Adoption is the decision to deploy.
Operationalization is the decision
to own what it produces.
Most health systems
have spent a decade on the first.
Almost none have spent
a decade on the second.
I watched this from the inside.
Clinician after clinician
starting the day under a load
no infrastructure was built to hold.
Twenty patients.
Multiple systems.
Hours of synthesis
before the first decision of the day.
The AI did not reduce that load.
It added more to carry.
More outputs.
More recommendations.
More volume reaching the bedside
with no named owner
at the point where the AI stops
and the clinician starts.
That point has a name.
The Accountability Gap™.
It opens the moment
named decision authority disappears.
It closes the moment
two seats are filled.
A Governance Owner
who holds the charter, the commission, and the cover.
A Decision Owner
who decides, documents, and defends.
Empty those seats,
and the institution has adopted clinical AI.
Fill them,
and it has operationalized it.
That is the entire distinction.
You have adopted clinical AI.
You already know which seat
you have not filled.
Mo Johnson, MD MBA is a cardiothoracic surgeon and the founder of GPe Research. Field Notes are short dispatches from the clinical AI accountability frontier, published alongside the MedicoVigilance™ newsletter at medicovigilance.org.
Follow the work on LinkedIn: linkedin.com/in/mo-johnson