ArticleBMC health services research2025
Managing a "responsibility vacuum" in AI monitoring and governance in healthcare: a qualitative study.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- The Continuity Trap in Data Science Health Research.Journal of medical Internet research · 2026Article
- Artificial intelligence needs better health systems to reduce inequalities.NPJ digital medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite the increasing implementation of artificial intelligence (AI) and machine learning (ML) technologies in healthcare, their long-term safety, effectiveness, and equity remain compromised by a lack of sustained oversight. This study explores the phenomenon of a "responsibility vacuum" in AI governance, wherein maintenance and monitoring tasks are poorly defined, inconsistently performed, and undervalued across healthcare systems.
methodsWe conducted semi-structured interviews with 21 experts involved in AI implementation in healthcare, including clinicians, clinical informaticists, computer scientists, and legal/policy professionals. Participants were recruited through purposive and snowball sampling. Interviews were transcribed, coded, and analyzed using abductive qualitative methods to identify themes related to maintenance practices, institutional incentives, and responsibility attribution.
resultsParticipants widely recognized that AI models degrade over time due to factors such as data drift, changes in clinical practice, and poor generalizability. However, monitoring practices remain ad hoc and fragmented, with few institutions investing in structured oversight infrastructure. This "responsibility vacuum" is perpetuated by institutional incentives favoring rapid innovation and strategic ignorance of AI failures. Despite these challenges, some participants described grassroots efforts to monitor and maintain AI systems, drawing inspiration from fields such as radiology, laboratory medicine, and transportation safety.
conclusionsOur findings suggest that institutional and cultural forces in healthcare deprioritize the maintenance of AI tools, creating a governance gap that may lead to patient harm and inequitable outcomes. Addressing this responsibility vacuum will require formalized accountability structures, interdisciplinary collaboration, and policy reforms that center long-term safety and equity. Without such changes, AI/ML technologies designed to improve patient health may introduce new forms of harm, ultimately eroding trust in AI and machine learning for healthcare.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.