_version_ 1866909825510670336
author Noori, Ayush
Rodman, Adam
Karthikesalingam, Alan
Mateen, Bilal A.
Longhurst, Christopher A.
Yang, Daniel
deBronkart, Dave
Galea, Gauden
Wolf III, Harold F.
Waxman, Jacob
Mandel, Joshua C.
Rotich, Juliana
Mandl, Kenneth D.
Mustafa, Maryam
Miles, Melissa
Shah, Nigam H.
Lee, Peter
Korom, Robert
Mahoney, Scott
Hain, Seth
Wong, Tien Yin
Mundel, Trevor
Natarajan, Vivek
Dagan, Noa
Clifton, David A.
Balicer, Ran D.
Kohane, Isaac S.
Zitnik, Marinka
author_facet Noori, Ayush
Rodman, Adam
Karthikesalingam, Alan
Mateen, Bilal A.
Longhurst, Christopher A.
Yang, Daniel
deBronkart, Dave
Galea, Gauden
Wolf III, Harold F.
Waxman, Jacob
Mandel, Joshua C.
Rotich, Juliana
Mandl, Kenneth D.
Mustafa, Maryam
Miles, Melissa
Shah, Nigam H.
Lee, Peter
Korom, Robert
Mahoney, Scott
Hain, Seth
Wong, Tien Yin
Mundel, Trevor
Natarajan, Vivek
Dagan, Noa
Clifton, David A.
Balicer, Ran D.
Kohane, Isaac S.
Zitnik, Marinka
contents Modern computer systems often rely on syslog, a simple, universal protocol that records every critical event across heterogeneous infrastructure. However, healthcare's rapidly growing clinical AI stack has no equivalent. As hospitals rush to pilot large language models and other AI-based clinical decision support tools, we still lack a standard way to record how, when, by whom, and for whom these AI models are used. Without that transparency and visibility, it is challenging to measure real-world performance and outcomes, detect adverse events, or correct bias or dataset drift. In the spirit of syslog, we introduce MedLog, a protocol for event-level logging of clinical AI. Any time an AI model is invoked to interact with a human, interface with another algorithm, or act independently, a MedLog record is created. This record consists of nine core fields: header, model, user, target, inputs, artifacts, outputs, outcomes, and feedback, providing a structured and consistent record of model activity. To encourage early adoption, especially in low-resource settings, and minimize the data footprint, MedLog supports risk-based sampling, lifecycle-aware retention policies, and write-behind caching; detailed traces for complex, agentic, or multi-stage workflows can also be captured under MedLog. MedLog can catalyze the development of new databases and software to store and analyze MedLog records. Realizing this vision would enable continuous surveillance, auditing, and iterative improvement of medical AI, laying the foundation for a new form of digital epidemiology.
format Preprint
id arxiv_https___arxiv_org_abs_2510_04033
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle A global log for medical AI
Noori, Ayush
Rodman, Adam
Karthikesalingam, Alan
Mateen, Bilal A.
Longhurst, Christopher A.
Yang, Daniel
deBronkart, Dave
Galea, Gauden
Wolf III, Harold F.
Waxman, Jacob
Mandel, Joshua C.
Rotich, Juliana
Mandl, Kenneth D.
Mustafa, Maryam
Miles, Melissa
Shah, Nigam H.
Lee, Peter
Korom, Robert
Mahoney, Scott
Hain, Seth
Wong, Tien Yin
Mundel, Trevor
Natarajan, Vivek
Dagan, Noa
Clifton, David A.
Balicer, Ran D.
Kohane, Isaac S.
Zitnik, Marinka
Artificial Intelligence
Modern computer systems often rely on syslog, a simple, universal protocol that records every critical event across heterogeneous infrastructure. However, healthcare's rapidly growing clinical AI stack has no equivalent. As hospitals rush to pilot large language models and other AI-based clinical decision support tools, we still lack a standard way to record how, when, by whom, and for whom these AI models are used. Without that transparency and visibility, it is challenging to measure real-world performance and outcomes, detect adverse events, or correct bias or dataset drift. In the spirit of syslog, we introduce MedLog, a protocol for event-level logging of clinical AI. Any time an AI model is invoked to interact with a human, interface with another algorithm, or act independently, a MedLog record is created. This record consists of nine core fields: header, model, user, target, inputs, artifacts, outputs, outcomes, and feedback, providing a structured and consistent record of model activity. To encourage early adoption, especially in low-resource settings, and minimize the data footprint, MedLog supports risk-based sampling, lifecycle-aware retention policies, and write-behind caching; detailed traces for complex, agentic, or multi-stage workflows can also be captured under MedLog. MedLog can catalyze the development of new databases and software to store and analyze MedLog records. Realizing this vision would enable continuous surveillance, auditing, and iterative improvement of medical AI, laying the foundation for a new form of digital epidemiology.
title A global log for medical AI
topic Artificial Intelligence
url https://arxiv.org/abs/2510.04033