A team led by Dr. R. Andrew Taylor from UVA Health and Dr. Arwen B.L. Declan of Clemson University has introduced a new framework designed to assist hospitals in incorporating artificial intelligence (AI) in ways that prioritize both operational efficiency and patient care quality.
Recognizing the transformative potential of AI in healthcare, Taylor and Declan aimed to maintain the sector’s ethical commitments to patients and local communities while navigating the urgency for hospitals to swiftly implement AI solutions—sometimes without adequate guidelines to assess their value beyond mere financial metrics. Their newly proposed Total Mission Value framework is particularly timely, given the increasing urgency for healthcare institutions to adopt AI technologies.
At the core of their framework is a hierarchy that places patient care and the overall patient experience at the pinnacle of a structure grounded in ethical standards, all while being reinforced by economic sustainability. They emphasize that AI should enhance the capabilities of healthcare professionals rather than merely add to their burdens or replace them.
Taylor, who holds the position of vice chair of research and innovation in the Department of Emergency Medicine at the University of Virginia School of Medicine, remarked, “AI is being integrated into medicine at an unprecedented pace, yet hospitals lack a cohesive evaluation method for these technologies. Conventional assessments often focus solely on costs, as they are the most straightforward to gauge. This framework is intended to offer organizations a structured approach to evaluate the comprehensive benefits of an AI tool—taking into account its impact on patients, staff, and care quality.”
In their published paper, the authors acknowledge the dual aspects of AI’s potential. “While AI could expedite care delivery, enhance diagnostic precision, and improve cost-efficiency, it also risks introducing biases, reducing transparency, displacing the workforce, and undermining the patient-clinician relationship,” they caution.
They point out the conventional focus on cost in technology evaluations creates a gap in comprehensive decision-making. Their framework aims to integrate five ethically centered priorities: patient care, staff experience, hospital operations, financial implications, and educational and research activities.
Placing patient care at the framework's summit underscores the need for “patient-centered” practices characterized by integrity, trust, compassion, and respect. In addition, the category focusing on staff experience advocates for harnessing AI to foster team development and interdisciplinary collaboration.
Declan highlighted the importance of assessing AI tools more broadly. “With a plethora of new AI products being promoted to enhance healthcare, the challenge lies in identifying which truly deliver benefits,” she explained, emphasizing the necessity to evaluate AI's impact across clinical, operational, and financial spectrums while keeping patient welfare as the guiding principle in every evaluation.
In closing, Taylor and Declan stress the importance of keeping patient care as the healthcare sector's “central, defining mission.”
Taylor added, “We believe that maintaining this mission at the forefront will not only facilitate robust AI adoption but will also foster the necessary trust among patients and clinicians. Ultimately, technology should enable us to improve patient care, and if we prioritize this goal, improved efficiency and cost savings are likely to follow.”
The framework has been published in the open-access journal npj Digital Medicine, making it available for public reading. Taylor has also disclosed that he received a grant from Beckman Coulter for the assessment of a clinical decision-making tool known as TriageGo and serves as an advisor for VeraHealth.
For those interested in staying updated on the latest advancements in medical research from UVA and the new Paul and Diane Manning Institute of Biotechnology, the Making of Medicine blog is a valuable resource.
