Monitoring Deployed AI Systems in Health Care

Fuente: arXiv
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Main Authors: Keyes, Timothy, Callahan, Alison, Pandya, Abby S., Ambers, Nerissa, Banda, Juan M., Fuentes, Miguel, Lugtu, Carlene, Masariya, Pranav, Nallan, Srikar, O'Brien, Connor, Wang, Thomas, Alsentzer, Emily, Chen, Jonathan H., Dash, Dev, Eisenberg, Matthew A., Garcia, Patricia, Kotecha, Nikesh, Revri, Anurang, Pfeffer, Michael A., Shah, Nigam H., Jain, Sneha S.
Format: Preprint
Published: 2025
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_version_ 1866912827081490432
author Keyes, Timothy
Callahan, Alison
Pandya, Abby S.
Ambers, Nerissa
Banda, Juan M.
Fuentes, Miguel
Lugtu, Carlene
Masariya, Pranav
Nallan, Srikar
O'Brien, Connor
Wang, Thomas
Alsentzer, Emily
Chen, Jonathan H.
Dash, Dev
Eisenberg, Matthew A.
Garcia, Patricia
Kotecha, Nikesh
Revri, Anurang
Pfeffer, Michael A.
Shah, Nigam H.
Jain, Sneha S.
author_facet Keyes, Timothy
Callahan, Alison
Pandya, Abby S.
Ambers, Nerissa
Banda, Juan M.
Fuentes, Miguel
Lugtu, Carlene
Masariya, Pranav
Nallan, Srikar
O'Brien, Connor
Wang, Thomas
Alsentzer, Emily
Chen, Jonathan H.
Dash, Dev
Eisenberg, Matthew A.
Garcia, Patricia
Kotecha, Nikesh
Revri, Anurang
Pfeffer, Michael A.
Shah, Nigam H.
Jain, Sneha S.
contents Post-deployment monitoring of artificial intelligence (AI) systems in health care is essential to ensure their safety, quality, and sustained benefit-and to support governance decisions about which systems to update, modify, or decommission. Motivated by these needs, we developed a framework for monitoring deployed AI systems grounded in the mandate to take specific actions when they fail to behave as intended. This framework, which is now actively used at Stanford Health Care, is organized around three complementary principles: system integrity, performance, and impact. System integrity monitoring focuses on maximizing system uptime, detecting runtime errors, and identifying when changes to the surrounding IT ecosystem have unintended effects. Performance monitoring focuses on maintaining accurate system behavior in the face of changing health care practices (and thus input data) over time. Impact monitoring assesses whether a deployed system continues to have value in the form of benefit to clinicians and patients. Drawing on examples of deployed AI systems at our academic medical center, we provide practical guidance for creating monitoring plans based on these principles that specify which metrics to measure, when those metrics should be reviewed, who is responsible for acting when metrics change, and what concrete follow-up actions should be taken-for both traditional and generative AI. We also discuss challenges to implementing this framework, including the effort and cost of monitoring for health systems with limited resources and the difficulty of incorporating data-driven monitoring practices into complex organizations where conflicting priorities and definitions of success often coexist. This framework offers a practical template and starting point for health systems seeking to ensure that AI deployments remain safe and effective over time.
format Preprint
id arxiv_https___arxiv_org_abs_2512_09048
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Monitoring Deployed AI Systems in Health Care
Keyes, Timothy
Callahan, Alison
Pandya, Abby S.
Ambers, Nerissa
Banda, Juan M.
Fuentes, Miguel
Lugtu, Carlene
Masariya, Pranav
Nallan, Srikar
O'Brien, Connor
Wang, Thomas
Alsentzer, Emily
Chen, Jonathan H.
Dash, Dev
Eisenberg, Matthew A.
Garcia, Patricia
Kotecha, Nikesh
Revri, Anurang
Pfeffer, Michael A.
Shah, Nigam H.
Jain, Sneha S.
Other Quantitative Biology
Artificial Intelligence
Post-deployment monitoring of artificial intelligence (AI) systems in health care is essential to ensure their safety, quality, and sustained benefit-and to support governance decisions about which systems to update, modify, or decommission. Motivated by these needs, we developed a framework for monitoring deployed AI systems grounded in the mandate to take specific actions when they fail to behave as intended. This framework, which is now actively used at Stanford Health Care, is organized around three complementary principles: system integrity, performance, and impact. System integrity monitoring focuses on maximizing system uptime, detecting runtime errors, and identifying when changes to the surrounding IT ecosystem have unintended effects. Performance monitoring focuses on maintaining accurate system behavior in the face of changing health care practices (and thus input data) over time. Impact monitoring assesses whether a deployed system continues to have value in the form of benefit to clinicians and patients. Drawing on examples of deployed AI systems at our academic medical center, we provide practical guidance for creating monitoring plans based on these principles that specify which metrics to measure, when those metrics should be reviewed, who is responsible for acting when metrics change, and what concrete follow-up actions should be taken-for both traditional and generative AI. We also discuss challenges to implementing this framework, including the effort and cost of monitoring for health systems with limited resources and the difficulty of incorporating data-driven monitoring practices into complex organizations where conflicting priorities and definitions of success often coexist. This framework offers a practical template and starting point for health systems seeking to ensure that AI deployments remain safe and effective over time.
title Monitoring Deployed AI Systems in Health Care
topic Other Quantitative Biology
Artificial Intelligence
url https://arxiv.org/abs/2512.09048