“Brilliant AI Doctor” in Rural Clinics: Challenges in AI-Powered Clinical Decision Support System Deployment

Abstract

Artificial intelligence (AI) technology has been increasingly used in the\nimplementation of advanced Clinical Decision Support Systems (CDSS). Research\ndemonstrated the potential usefulness of AI-powered CDSS (AI-CDSS) in clinical\ndecision making scenarios. However, post-adoption user perception and\nexperience remain understudied, especially in developing countries. Through\nobservations and interviews with 22 clinicians from 6 rural clinics in China,\nthis paper reports the various tensions between the design of an AI-CDSS system\n("Brilliant Doctor") and the rural clinical context, such as the misalignment\nwith local context and workflow, the technical limitations and usability\nbarriers, as well as issues related to transparency and trustworthiness of\nAI-CDSS. Despite these tensions, all participants expressed positive attitudes\ntoward the future of AI-CDSS, especially acting as "a doctor's AI assistant" to\nrealize a Human-AI Collaboration future in clinical settings. Finally we draw\non our findings to discuss implications for designing AI-CDSS interventions for\nrural clinical contexts in developing countries.\n

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