Three questions.
Then the deployment had an owner.
No committee cycle.
No three months of governance review.
No "let legal look at this first."
Three questions to close the gap.
Then a named seat.
The thing that shifted was not the workflow.
The ceiling moved.
Most institutions name the technology.
Most charters name the committee.
Most clinical AI deployments never name the seat.
When that changes,
something surfaces.
Judgment.
The Governance Owner.
The Decision Owner.
Three questions name both.
↳ Who is the Governance Owner?
↳ Who is the Decision Owner?
↳ Where is the Handoff documented?
That is the whole governance question.
Three lines.
Two seats.
One Handoff.
The constraint did not disappear.
It moved one floor up.
To where it should have been the whole time.
Most health system leaders call this a workflow problem.
That is not wrong.
But it is the second problem.
The first one is that deployment
consumed all the space
where judgment should live.
You never reached the real bottleneck
because you were always managing the first one.
The Accountability Gap™ (TAG™)
does not close with a framework.
It closes when naming the owner
becomes easier than working around one.
You already know which clinical AI deployment
in your institution has no named owner.
The bottleneck is not the workflow.
It never was.
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