State of the AI: Post-Deployment Monitoring of Radiology-Focused Internally Developed AI

Articles on the development of medical image artificial intelligence (AI) algorithms are numerous in the literature, but deployment to clinical practice is infrequently discussed. The Enterprise Radiology Framework for AI Software Technology Team at Mayo Clinic has been focused on bridging the gap in clinical translation of medical image AI algorithms since its inception in 2019. During this time, we have released 17 algorithms into our radiology clinical practice. Recently, we have placed an increased focus on monitoring these algorithms, as there are few reports with practical experience documented in the literature. Our increased monitoring efforts include daily, weekly, and yearly monitoring of utilization, failure modes, data drift, and end-user feedback through automated alerts, dedicated dashboards, and pointed investigations to enable optimal algorithmic processing. End-user feedback is elicited yearly during annual reviews to ensure clinical needs are still being met. Automated monitoring has enabled earlier identification of problems, such as images no longer routing through the orchestration engine to the appropriate algorithm, minimizing potential disruption to the clinical practice and ensuring continued algorithmic utilization. Monitoring has also reinforced the importance of key aspects of interdisciplinary research and translation, such as early discussions on clinical needs coupled with technological ability and proper training. By providing our experience in and continuing to improve monitoring methods as a community, we can all minimize risk and maximize the benefits of medical pixel-based AI.