This would seem to be basic common sense, but a UVA Health emergency medicine doctor and a colleague at Clemson felt the need to spell out a framework for how hospitals integrate AI into their work, and to stress the importance of making sure AI is used, primarily, to enhance patient care.
Imagine that.
“AI is being adopted in medicine at a scope and velocity we have never seen before, but hospitals haven’t had a good way to weigh these decisions as a whole,” said R. Andrew Taylor, vice chair of research and innovation for the University of Virginia School of Medicine’s Department of Emergency Medicine.
“Typical approaches tend to measure cost, because cost is the easiest thing to measure. We built this framework to give organizations a structured way to also weigh what an AI tool does for patients, for staff and for the quality of care,” Taylor said.
Our American healthcare system focuses on cost because it is run like a business, not a public trust, but that’s just because we do everything bassackwards here in the States.
The framework on AI from Taylor and Arwen B.L. Declan, a clinical assistant professor in the School of Health Research at Clemson, is meant to ensure healthcare remains “rooted in its ethical obligations” to serve patients, communities and local workforces, they say in a new paper outlining their creation, which has been published in npj digital medicine.
Their Total Mission Value framework arrives as hospitals face mounting pressure to adopt AI quickly, often with little practical guidance on how to weigh a tool’s worth beyond its price.
Declan and Taylor’s framework puts patient care and the patient experience at the top of a pyramid built on a foundation of ethics and supported by a base of economic sustainability.
It emphasizes that AI should support care providers in their mission rather than replace them or simply create more work for them.
The researchers are candid that AI’s promise cuts both ways:
“AI tools could enhance care speed, diagnostic accuracy and costs efficiency while supporting population health, scientific inquiry and operational management,” they note in their paper. “However, they also introduce risks of bias, opacity, workforce displacement and erosion of the patient-clinician relationship that are invisible to cost-focused analyses.”
Declan and Taylor note that hospitals have lacked a structured way to weigh these choices as a whole — the standard approaches for evaluating a new technology tend to center on cost.
Their framework is built to fill that gap, integrating five “ethically grounded” priorities:
- patient care
- staff experience
- hospital operations
- economic impact
- education and research
Declan emphasizes that realizing AI’s full potential means resisting the urge to evaluate it narrowly.
“Hospitals are seeing a huge number of new AI tools marketed to improve healthcare. The challenge is to figure out which ones actually will,” Declan said. “That requires weighing an AI tool’s impact across clinical, operational and financial dimensions, while keeping patient care at the center of every decision.”
Ultimately, it is vital that hospitals remember that patient care is their “central, defining mission,” Declan and Taylor write.
“Our hope is that keeping the mission front and center actually speeds good AI adoption rather than slowing it down, because it builds the trust that patients and clinicians need,” Taylor said. “Technology should help us take better care of people. If we keep that as the goal, the efficiency and the savings tend to follow.”
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Chris Graham
