An institutional framework to support ethical fair and equitable artificial intelligence augmented care
Abstract Coordinated access to multi-domain health data can facilitate the development and implementation of artificial intelligence-augmented clinical decision support (AI-CDS). However, scalable institutional frameworks supporting these activities are lacking. We present the PULSE framework, aimed...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-02-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-025-01490-9 |
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| Summary: | Abstract Coordinated access to multi-domain health data can facilitate the development and implementation of artificial intelligence-augmented clinical decision support (AI-CDS). However, scalable institutional frameworks supporting these activities are lacking. We present the PULSE framework, aimed to establish an integrative and ethically governed ecosystem for the patient-guided, patient-contextualized use of multi-domain health data for AI-augmented care. We describe deliverables related to stakeholder engagement and infrastructure development to support routine engagement of patients for consent-guided data abstraction, pre-processing, and cloud migration to support AI-CDS model development and surveillance. Central focus is placed on the routine collection of social determinants of health and patient self-reported health status to contextualize and evaluate models for fair and equitable use. Inaugural feasibility is reported for over 30,000 consecutively engaged patients. The described framework, conceptually developed to support a multi-site cardiovascular institute, is translatable to other disease domains, offering a validated architecture for use by large-scale tertiary care institutions. |
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| ISSN: | 2398-6352 |