journal article Jan 27, 2022

Implementation Frameworks for Artificial Intelligence Translation Into Health Care Practice: Scoping Review

Abstract
Background
Significant efforts have been made to develop artificial intelligence (AI) solutions for health care improvement. Despite the enthusiasm, health care professionals still struggle to implement AI in their daily practice.


Objective
This paper aims to identify the implementation frameworks used to understand the application of AI in health care practice.


Methods
A scoping review was conducted using the Cochrane, Evidence Based Medicine Reviews, Embase, MEDLINE, and PsycINFO databases to identify publications that reported frameworks, models, and theories concerning AI implementation in health care. This review focused on studies published in English and investigating AI implementation in health care since 2000. A total of 2541 unique publications were retrieved from the databases and screened on titles and abstracts by 2 independent reviewers. Selected articles were thematically analyzed against the Nilsen taxonomy of implementation frameworks, and the Greenhalgh framework for the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) of health care technologies.


Results
In total, 7 articles met all eligibility criteria for inclusion in the review, and 2 articles included formal frameworks that directly addressed AI implementation, whereas the other articles provided limited descriptions of elements influencing implementation. Collectively, the 7 articles identified elements that aligned with all the NASSS domains, but no single article comprehensively considered the factors known to influence technology implementation. New domains were identified, including dependency on data input and existing processes, shared decision-making, the role of human oversight, and ethics of population impact and inequality, suggesting that existing frameworks do not fully consider the unique needs of AI implementation.


Conclusions
This literature review demonstrates that understanding how to implement AI in health care practice is still in its early stages of development. Our findings suggest that further research is needed to provide the knowledge necessary to develop implementation frameworks to guide the future implementation of AI in clinical practice and highlight the opportunity to draw on existing knowledge from the field of implementation science.
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References
48
[3]
The practical implementation of artificial intelligence technologies in medicine

Jianxing He, Sally L. Baxter, Jie Xu et al.

Nature Medicine 10.1038/s41591-018-0307-0
[5]
[6]
Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Laura J Damschroder, David C Aron, Rosalind E Keith et al.

Implementation Science 10.1186/1748-5908-4-50
[9]
Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations

TRISHA GREENHALGH, Glenn Robert, FRASER MACFARLANE et al.

The Milbank Quarterly 10.1111/j.0887-378x.2004.00325.x
[10]
Alhashmi, SF Proceedings of the International Conference on Artificial Intelligence and Computer Vision (AICV2020) (2020)
[19]
Scoping studies: towards a methodological framework

Hilary Arksey, Lisa O'Malley

International Journal of Social Research Methodolo... 10.1080/1364557032000119616
[20]
Scoping reviews: time for clarity in definition, methods, and reporting

Heather L. Colquhoun, Danielle Levac, Kelly K. O'Brien et al.

Journal of Clinical Epidemiology 10.1016/j.jclinepi.2014.03.013
[23]
PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Andrea C. Tricco, Erin Lillie, Wasifa Zarin et al.

Annals of Internal Medicine 10.7326/m18-0850
[24]
Scoping studies: advancing the methodology

Danielle Levac, Heather Colquhoun, Kelly K O'Brien

Implementation Science 10.1186/1748-5908-5-69
[29]
Artificial Intelligence and Surgical Decision-making

Tyler J. Loftus, Patrick J. Tighe, Amanda C. Filiberto et al.

JAMA Surgery 10.1001/jamasurg.2019.4917
[31]
Big data and machine learning algorithms for health-care delivery

Kee Yuan Ngiam, Ing Wei Khor

The Lancet Oncology 10.1016/s1470-2045(19)30149-4
[33]
Methods for the thematic synthesis of qualitative research in systematic reviews

James Thomas, Angela Harden

BMC Medical Research Methodology 10.1186/1471-2288-8-45
[34]
Artificial Intelligence (AI): Multidisciplinary perspectives on emerging challenges, opportunities, and agenda for research, practice and policy

Yogesh K. Dwivedi, Laurie Hughes, Elvira Ismagilova et al.

International Journal of Information Management 10.1016/j.ijinfomgt.2019.08.002
[44]
High-Level Expert Group on Artificial IntelligenceEthics guidelines for trustworthy AIEuropean Commission, Directorate-General for Communications Networks, Content and Technology20192021-07-10BrusselsPublications Office of the European Unionhttps://ec.europa.eu/newsroom/dae/document.cfm?doc_id=60419
[45]
Artificial Intelligence and the Public Sector—Applications and Challenges

Bernd W. Wirtz, Jan C. Weyerer, Carolin Geyer

International Journal of Public Administration 10.1080/01900692.2018.1498103
[48]
A scoping review of scoping reviews: advancing the approach and enhancing the consistency

Mai T. Pham, Andrijana Rajić, Judy D. Greig et al.

Research Synthesis Methods 10.1002/jrsm.1123
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Metrics
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Citations
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References
Details
Published
Jan 27, 2022
Vol/Issue
24(1)
Pages
e32215
Cite This Article
Fabio Gama, Daniel Tyskbo, Jens Nygren, et al. (2022). Implementation Frameworks for Artificial Intelligence Translation Into Health Care Practice: Scoping Review. Journal of Medical Internet Research, 24(1), e32215. https://doi.org/10.2196/32215